Individual
LORI WIEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC, M.ED., NCC
Contact information
Practice address
2023 CATO AVE STE 101, STATE COLLEGE, PA 16801-2765
(814) 308-8375
Mailing address
793 WESTERLY PKWY, STATE COLLEGE, PA 16801-4227
(301) 807-2245
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC000045
PA
101YM0800X
Mental Health Counselor
APC000045
PA
101YP2500X
Professional Counselor
APC000045
PA
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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