Individual
CHRISTINE WIELGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11518 N PORT WASHINGTON RD STE 202, MEQUON, WI 53092-3443
(262) 244-6177
(262) 299-3040
Mailing address
1035 W GLEN OAKS LN STE 110, MEQUON, WI 53092-3392
(262) 244-6177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110849
TX
1041C0700X
Clinical Social Worker
149.019033
IL
1041C0700X
Clinical Social Worker
9464-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110201
—
WI
Enumeration date
10/01/2012
Last updated
09/05/2023
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