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Individual

DEBRA ANN WIEDMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
7020 STATE RT. 12, LOWVILLE, NY 13367
(315) 376-1700
(315) 376-6164
Mailing address
7020 STATE RT. 12, LOWVILLE, NY 13367
(315) 376-1700
(315) 376-6164

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
008201-1
NY

Other

Enumeration date
12/30/2015
Last updated
01/20/2016
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