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Individual
WILLIAM C WIESE
Active
Individual
WILLIAM C WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150.104351
IL
1041C0700X
Clinical Social Worker
Primary
149.024958
IL
Other
Enumeration date
03/14/2022
Last updated
10/18/2022
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