Individual
DONNA MARIE WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6885 CLIFFDALE RD STE 202, FAYETTEVILLE, NC 28314-2834
(910) 339-0400
(910) 339-0396
Mailing address
1502 W NC HIGHWAY 54, STE 103, DURHAM, NC 27707-5572
(919) 354-0840
(919) 748-4441
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3027
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046NC
BCBS PIN
NY
05
—
6000810
—
NC
Enumeration date
11/01/2006
Last updated
12/04/2019
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