Provider Demographics
NPI:1639286552
Name:TIMMER, DAVID FRANCIS (MSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FRANCIS
Last Name:TIMMER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 S 108TH ST
Mailing Address - Street 2:12B
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1368
Mailing Address - Country:US
Mailing Address - Phone:414-529-2591
Mailing Address - Fax:414-529-2669
Practice Address - Street 1:5300 S 108TH ST
Practice Address - Street 2:12B
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1368
Practice Address - Country:US
Practice Address - Phone:414-529-2591
Practice Address - Fax:414-529-2669
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1722 1231041C0700X
WI284 124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39653900Medicaid