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Individual

LISA E. WIENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.,LP

Contact information

Practice address
3505 PERRYSVILLE AVE, SUITE #2, PITTSBURGH, PA 15214-2212
(724) 773-0624
Mailing address
3505 PERRYSVILLE AVE, SUITE #2, PITTSBURGH, PA 15214-2212

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
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