Individual
DAVID WIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
1764 W ASPEN LANE, LOA, UT 84747
(505) 231-5031
Mailing address
PO BOX 1456, LYMAN, UT 84749-1456
(505) 231-5031
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9850664-6004
UT
101YM0800X
Mental Health Counselor
98506646009
UT
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
05/08/2015
Last updated
07/26/2018
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