Individual
DREW RILEY WIESEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2549 N STOKESBERRY PL, MERIDIAN, ID 83646-1144
(208) 369-9168
Mailing address
3104 N VENABLE LN, MERIDIAN, ID 83646-1820
(208) 392-5139
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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