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Individual
MS. MAUREEN WIESE-WAIBEL
Active
Individual
MS. MAUREEN WIESE-WAIBEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04746700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11235188
CAQH PROVIDER NO.
NJ
01
—
141606
MEDICARE PTAN
NJ
01
—
262135919
TAX ID CHANGE
NJ
01
—
296033
MHN PROVIDER NUMBER
NJ
01
—
P2912168
OXFORD PROVIDER NUMBER
NJ
Enumeration date
10/03/2006
Last updated
03/22/2013
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