Provider Demographics
NPI:1083110159
Name:NIEMCZYK, ANNA (QMHS-M)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:NIEMCZYK
Suffix:
Gender:F
Credentials:QMHS-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2070
Mailing Address - Country:US
Mailing Address - Phone:614-842-7649
Mailing Address - Fax:937-606-3132
Practice Address - Street 1:31 S MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2070
Practice Address - Country:US
Practice Address - Phone:146-842-7649
Practice Address - Fax:937-606-3132
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator