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Individual
MRS. JOANNE BRADLEY WIETERS
Active
Individual
MRS. JOANNE BRADLEY WIETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0797
TX
1041C0700X
Clinical Social Worker
I0219
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0797
LCSW LICENSE
TX
01
—
I0219
LCSW LICENSE
NM
Enumeration date
10/05/2006
Last updated
09/20/2026
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