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Individual

DR. DUSTIN WIELT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1601 PERDIDO ST, SOUTHEAST LOUISIANA VETERAN HEALTHCARE SYSTEM, NEW ORLEANS, LA 70112-1262
(504) 988-8277
Mailing address
910 SAINT PHILIP ST, APT #A, NEW ORLEANS, LA 70116-2408
(504) 452-8438

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1172
LA

Other

Enumeration date
05/03/2012
Last updated
05/03/2012
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