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Individual

MRS. NICOLE LYNNE WIESEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
214 DRUID OAKS NE, ATLANTA, GA 30329-3256
(404) 603-6606
Mailing address
214 DRUID OAKS NE, ATLANTA, GA 30329-3256
(404) 603-6606

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW3351
FL
104100000X
Social Worker
Primary
469
CA

Other

Enumeration date
04/01/2014
Last updated
04/01/2014
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