Individual
NICOLE KRISTINE WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
609 NE BAKER ST STE 260, MCMINNVILLE, OR 97128-4950
(971) 213-5025
Mailing address
609 NE BAKER ST STE 260, MCMINNVILLE, OR 97128-4950
(971) 213-5025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
T2414
OR
106H00000X
Marriage & Family Therapist
R7065
OR
106H00000X
Marriage & Family Therapist
Primary
T2414
OR
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/22/2020
Last updated
02/21/2024
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