Individual
DR. JULIE A. WIESE
Active
Individual
DR. JULIE A. WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3090271205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10700772D103
INTRMTN. HEALTH CARE
UT
01
—
292740
DESERET MUTUAL
UT
01
—
346475
UNKNOWN CARRIER
UT
01
—
942938348W11
EDUCATORS MUTUAL
UT
Enumeration date
12/05/2005
Last updated
08/05/2013
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