Individual
MRS. JAMIE ANNE WIENEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
301 PINEHAVEN STREET EXT, LAURENS, SC 29360-2671
(864) 984-6584
(864) 984-6464
Mailing address
305 HUCK CT, MAULDIN, SC 29662-2595
(217) 721-4687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.002978
IL
224Z00000X
Occupational Therapy Assistant
Primary
2941
SC
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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