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Organization
JAMES D WIEDENHOEFT PARTNERSHIP
Active
Organization
JAMES D WIEDENHOEFT PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANN DAKE (FOUNDER/CEO)
(920) 986-3003
Entity
Organization
Contact information
Practice address
N5367 MAYFLOWER RD, SHIOCTON, WI 54170-8934
(920) 986-3003
(920) 986-3004
Mailing address
N5367 MAYFLOWER RD, SHIOCTON, WI 54170-8934
(920) 986-3003
(920) 986-3004
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
1447-226
WI
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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