Organization
WIELAND & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN LEE WIELAND PSY. D., HSPP (PRESIDENT)
(260) 483-7207
Entity
Organization
Contact information
Practice address
11123 PARKVIEW PLAZA DR, SUITE 200, FORT WAYNE, IN 46845
(260) 672-6510
(260) 672-6501
Mailing address
1415 MAGNAVOX WAY, SUITE 120, FORT WAYNE, IN 46804-1553
(260) 483-7207
(260) 483-0836
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360310A
—
IN
Enumeration date
02/05/2014
Last updated
02/05/2014
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