Individual
MRS. MAIKE WEGNER-KLEINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4486 COMMERCE DR STE A, BUFORD, GA 30518-7505
(470) 231-8725
Mailing address
4486 COMMERCE DR STE A, BUFORD, GA 30518-7505
(470) 231-8725
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001076
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11810716
CAQH
GA
01
—
MFT001076
PROFESSIONAL LICENSE
GA
Enumeration date
05/20/2007
Last updated
12/21/2019
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