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Individual
WENDY JEA THEIS
Active
Individual
WENDY JEA THEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP, LCSW, LMSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1383
NE
1041C0700X
Clinical Social Worker
007669
IA
1041C0700X
Clinical Social Worker
1444
NE
Other
Enumeration date
04/20/2011
Last updated
04/24/2015
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