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1528126703
WILTON JAN WIELENGA
STOCKTON, CA
NPI
1528126703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS 5681)
Enumeration Date
2006-12-04
Last Update Date
2007-07-08
Business Address
Mr. WILTON JAN WIELENGA LCSW
1755 W HAMMER LANE SUITE 1
STOCKTON, CA 95209-2900
Phone number: 209-477-9180
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Mailing Address
Mr. WILTON JAN WIELENGA LCSW
1755 W HAMMER LANE SUITE 1
STOCKTON, CA 95209-2900
Phone number: 209-477-9180
Copy
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