Individual
MARIA WIEBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 HUNDERTMARK RD STE 205, CHASKA, MN 55318-4551
(612) 446-3921
Mailing address
1295 WATERS WAY, WATERTOWN, MN 55388-4507
(612) 599-7681
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17714
MN
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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