Individual
KELLY ANN WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41155 POND VIEW DR, STERLING HEIGHTS, MI 48314-3891
(586) 571-9626
Mailing address
32100 TELEGRAPH RD STE 205, BINGHAM FARMS, MI 48025-2454
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
10/06/2024
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