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1467549964
KENNETH MAXIM WIEDEMANN
TUSTIN, CA
NPI
1467549964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: CA 17821)
Enumeration Date
2006-10-06
Last Update Date
2007-07-08
Business Address
Dr. KENNETH MAXIM WIEDEMANN Ph.D. Psychologist
14771 PLAZA DR STE L
TUSTIN, CA 92780-8012
Phone number: 714-731-1995
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Mailing Address
Dr. KENNETH MAXIM WIEDEMANN Ph.D. Psychologist
14771 PLAZA DR STE L
TUSTIN, CA 92780-8012
Phone number: 714-731-1995
Copy
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