Teresa Wiedemann LICSW

NPI 1063790509 - Social Worker - 1041C0700X

NPI Details
NPI 1063790509
Gender Female
Enumeration Date 08/02/2011
Last Updated 04/09/2012
Entity Type Individual
Active Over 5 years ago
Practice Location
139 RUSSET RD
WALLA WALLA WA, 99362-8253, US
Phone (509) 520-4370
Fax
Business Location
139 RUSSET RD
WALLA WALLA WA, 99362-8253, US
Phone (509) 520-4370
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Washington
License Number LW 60111377
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According to our database, Ms. Teresa Wiedemann LICSW NPI is 1063790509, taxonomy code is 1041C0700X and license number is LW 60111377, license state is located at Washington. Teresa Wiedemann LICSW physically located at 139 Russet Rd, Walla Walla WA, 99362-8253. NPI Number Teresa Wiedemann LICSW has the Individual type.

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1063790509 NPI number is provided on an as is basis without warranty of any kind. 1063790509 is maintained by the National Plan & Provider Enumeration System. The contents of Teresa Wiedemann LICSW are for informational purposes only.