| Jeff D Wiese Lcsw Pllc | |
|
5425 N Oracle Rd Ste 115 Tucson AZ 85704-3890 | |
| (520) 742-9166 | |
| (520) 742-9146 |
| Full Name | Jeff D Wiese Lcsw Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5425 N Oracle Rd Ste 115, Tucson, Arizona |
| Authorized Official Name and Position | Jeff D Wiese (OWNER) |
| Authorized Official Contact | 5207429166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff D Wiese Lcsw Pllc 5425 N Oracle Rd Ste 115 Tucson AZ 85704-3890 Ph: (520) 742-9166 | Jeff D Wiese Lcsw Pllc 5425 N Oracle Rd Ste 115 Tucson AZ 85704-3890 Ph: (520) 742-9166 |
| NPI Number | 1588736128 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588736128 | NPI | - | NPPES |
| LCSW0712 | Other | AZ | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCSW0712 (Arizona) | Primary |
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