Individual
AMBER WIEMELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4409 MAINE ST, QUINCY, IL 62305-5849
(217) 223-0423
Mailing address
502 N FULTON ST, PAYSON, IL 62360-1028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.017208
IL
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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