Individual
LISA E. WIENS
Active
Individual
LISA E. WIENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.,LP
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP4182
MN
103TC0700X
Clinical Psychologist
Primary
PS016409
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022415
PREFERRED ONE
MN
05
—
263519400
—
MN
01
—
55B83WI
BCBS OF MINNESOTA
MN
01
—
61 33656
UNITED BEHAVIORAL SYSTEMS
MN
Enumeration date
05/08/2007
Last updated
12/06/2016
Update your record
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