Individual
REBECCA WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4175 S ALAMO AVE, TUCSON, AZ 85707-4402
(520) 228-2615
Mailing address
4175 S ALAMO AVE, TUCSON, AZ 85707-4402
(025) 228-2615
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
62728
MT
1041C0700X
Clinical Social Worker
62728
MT
Other
Enumeration date
04/11/2023
Last updated
08/16/2024
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