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Individual
TIMOTHY ALLEN WIENECKE
Active
Individual
TIMOTHY ALLEN WIENECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001045
CO
101YM0800X
Mental Health Counselor
Primary
LPC.0014951
CO
Other
Enumeration date
11/12/2018
Last updated
11/27/2023
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