Individual
LYNN WIERDSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1115 W IRONWOOD DR, COEUR D ALENE, ID 83814-4936
(208) 665-7178
Mailing address
4279 IDEWILD LOOP APT 202, COEUR D ALENE, ID 83814-7155
(805) 440-3135
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60271238
WA
Other
Enumeration date
06/05/2007
Last updated
05/22/2014
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