Individual
TANA WIEBERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1623 E MARYLAND AVE, PHOENIX, AZ 85016-1301
(602) 359-3476
Mailing address
1623 E MARYLAND AVE, PHOENIX, AZ 85016-1301
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4312
AZ
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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