| NPI | 1124627633 |
|---|---|
| Former Name | ANGELA WIESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM M-11382) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NM M-11382) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2023-10-16 |