Individual
JILLIAN MARIE WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
555 CAMERON WAY UNIT 2, NORTH LIBERTY, IA 52317-4901
(319) 804-9312
Mailing address
1150 5TH ST STE 270, CORALVILLE, IA 52241-2933
(319) 800-9046
(319) 449-3845
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
101399
IA
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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