Individual
MRS. CHRISTINE MARIE VANDER WIELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1476 KENWOOD CTR, MENASHA, WI 54952-1134
(920) 720-8872
(920) 720-8873
Mailing address
1476 KENWOOD CTR, MENASHA, WI 54952-1134
(920) 720-8872
(920) 720-8873
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1453-121
WI
1041C0700X
Clinical Social Worker
Primary
7710-123
WI
Other
Enumeration date
06/18/2008
Last updated
03/21/2012
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