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NPI Code Detail

MEDICARE: DAVID J TIEMAN LPCC

MEDICARE: DAVID J TIEMAN LPCC
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
1101YM0800XMental Health CounselorE0003164 SUPVOH

General Provider Information

NPI Number : 1043480627
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID J TIEMAN LPCC
Provider Business Mailing Address
First Line : 1321 RESEARCH PARK DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2851
Country : US
Telephone Number : 937-427-3837
Fax Number : 937-427-4516
Provider Business Practice Location Address
First Line : 1321 RESEARCH PARK DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2851
Country : US
Telephone Number : 937-427-3837
Fax Number : 937-427-4516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2008
Last Update Date : 03/10/2008

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