Provider Demographics
NPI:1912575994
Name:NIEMANN, JOSHUA AARON (MT-BC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:AARON
Last Name:NIEMANN
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4051
Mailing Address - Country:US
Mailing Address - Phone:309-370-5307
Mailing Address - Fax:
Practice Address - Street 1:847 5TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2759
Practice Address - Country:US
Practice Address - Phone:507-236-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15728225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist