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1144630658
MICAH WIEDEMANN
LAS VEGAS, NV
NPI
1144630658
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-05-06
Last Update Date
2014-05-06
Business Address
-- MICAH WIEDEMANN
3001 LAKE EAST DR APT 2089
LAS VEGAS, NV 89117-2205
Phone number: 313-815-0055
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Mailing Address
-- MICAH WIEDEMANN
3001 LAKE EAST DR APT 2089
LAS VEGAS, NV 89117-2205
Phone number:
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