Individual
MRS. BERNADETTE LOIS VAN WIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
465 N PERRY ST, CONTINUING DAY TREATMENT (CDTP), JOHNSTOWN, NY 12095-1014
(518) 736-3962
(518) 762-0974
Mailing address
465 N PERRY ST, CONTINUING DAY TREATMENT (CDTP), JOHNSTOWN, NY 12095-1014
(518) 736-3962
(518) 762-0974
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
417321-1
NY
Other
Enumeration date
08/28/2008
Last updated
08/28/2008
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