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Individual

MRS. MARTHA JANE M WIENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
107 1/2 S MAIN ST, HILLSBORO, KS 67063-1525
(620) 382-5302
Mailing address
1657 KANZA, HILLSBORO, KS 67063-8100

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
2217
KS
1041C0700X
Clinical Social Worker
Primary
06033
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
82-1971814
KS
Enumeration date
08/16/2017
Last updated
11/07/2024
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