Individual
MS. MARIAN A WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
65936 HAVEN RIDGE RD, LENOX, MI 48050-1779
(586) 530-6783
Mailing address
65936 HAVEN RIDGE RD, LENOX, MI 48050-1779
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
52865
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52865
CERTIFIED THERAPEUTIC RECREATION SPECIALIST
MI
Enumeration date
12/18/2008
Last updated
12/18/2008
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