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NPI Code Detail

MEDICARE: NYIEMAH TWYMAN BA, CMHP, QMHP, QIDP

MEDICARE: NYIEMAH TWYMAN BA, CMHP, QMHP, QIDP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther TechnicianMI
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1649641069
Entity Type Code : Individual
Provider Name (Legal Business Name) : NYIEMAH TWYMAN BA, CMHP, QMHP, QIDP
Provider Business Mailing Address
First Line : PO BOX 289
Second Line :
City : MASON
State : MI
Zip : 48854-0289
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 38271 MOUND RD STE 300
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-3403
Country : US
Telephone Number : 586-477-2054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2015
Last Update Date : 04/24/2024

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