Individual
ANGIE WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, RBT
Contact information
Practice address
1012 NW GRAND BLVD, OKLAHOMA CITY, OK 73118-6000
(405) 594-8336
Mailing address
1012 NW GRAND BLVD, OKLAHOMA CITY, OK 73118-6000
(405) 594-8336
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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