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1609918838
MICHAEL WIEDERSTEIN
ELK GROVE, CA
NPI
1609918838
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: CA PSY 11582)
Enumeration Date
2007-02-13
Last Update Date
2007-07-08
Business Address
MICHAEL WIEDERSTEIN PH.D.
9120 TRUMBAUER WAY
ELK GROVE, CA 95758
Phone number: 916-662-5893
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Mailing Address
MICHAEL WIEDERSTEIN PH.D.
9120 TRUMBAUER WAY
ELK GROVE, CA 95758
Phone number: 916-662-5893
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