| NPI | 1982716122 |
|---|---|
| Former Name | GEORGIA M WIESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3046-125) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 3046-125) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-06-13 |