Individual
JESSICA M WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
34950 CHARDON RD STE 202, WILLOUGHBY HILLS, OH 44094-9162
(440) 510-5100
(440) 510-5151
Mailing address
37658 LAKE SHORE BLVD UNIT 1, EASTLAKE, OH 44095-1048
(440) 479-5145
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.1300702
OH
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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