Joanna Elise Wiese

NPI 1063711869 - Psychologist - 103T00000X

NPI Details
NPI 1063711869
Gender Female
Enumeration Date 03/18/2011
Last Updated 03/25/2016
Entity Type Individual
Active Over 5 years ago
Practice Location
101 BODIN CIR
DAVID GRANT MEDICAL CENTER
TRAVIS AFB CA, 94535-1809, US
Phone (707) 423-5174
Fax
Business Location
101 BODIN CIR
DAVID GRANT MEDICAL CENTER
TRAVIS AFB CA, 94535, US
Phone (707) 423-5174
Fax
Toxanomy
Taxonomy Code 103T00000X
License State
License Number
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According to our database, Ms. Joanna Elise Wiese NPI is 1063711869, taxonomy code is 103T00000X Joanna Elise Wiese physically located at 101 Bodin Cir, Travis Afb CA, 94535-1809. NPI Number Joanna Elise Wiese has the Individual type.

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1063711869 NPI number is provided on an as is basis without warranty of any kind. 1063711869 is maintained by the National Plan & Provider Enumeration System. The contents of Joanna Elise Wiese are for informational purposes only.