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NPI Code Detail

MEDICARE: BRENNA ELISE NEIMANIS LMSW

MEDICARE: BRENNA ELISE NEIMANIS LMSW
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
11041C0700XClinical Social Worker24144MD

General Provider Information

NPI Number : 1700447786
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENNA ELISE NEIMANIS LMSW
Provider Business Mailing Address
First Line : 440 E 22ND ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21218-5832
Country : US
Telephone Number : 224-388-0604
Fax Number :
Provider Business Practice Location Address
First Line : 2700 WASHINGTON AVE
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3115
Country : US
Telephone Number : 667-600-3981
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2019
Last Update Date : 06/21/2019

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Directions to “ BRENNA ELISE NEIMANIS LMSW” Practice Location

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