| NPI | 1790133742 |
|---|---|
| Doing Business As | DAVID E. NICODEMUS, JR. |
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD NICODEMUS Owner 610-921-3172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS007441L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS007441L) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |