Organization
VIERA PSYCHOLOGICAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WIESELER PSY.D. (OWNER)
(321) 704-1135
Entity
Organization
Contact information
Practice address
345 6TH AVE, INDIALANTIC, FL 32903-4301
(321) 951-2100
(321) 951-1204
Mailing address
345 6TH AVE, INDIALANTIC, FL 32903-4301
(321) 951-2100
(321) 951-1204
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7276
FL
Other
Enumeration date
10/20/2006
Last updated
03/23/2010
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