Tina Suzanne Wiesert
Social Worker, Clinical in Indianapolis, IN. Individual provider (NPI-1).
NPI number1801011069
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1801011069
- Entity type
- Individual (NPI-1)
- Name
- Tina Suzanne Wiesert
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 14, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34004969A | IN | Yes |
Practice location
3171 N Meridian StIndianapolis, IN 46208-4784
Phone 317-941-5010
Mailing address
3249 W 48th StIndianapolis, IN 46228-2103
Phone 317-299-2748
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