Individual
MS. DANIELLE LUCILLE WIETIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
116 HAMLIN AVE, EAST AURORA, NY 14052-1607
(716) 430-0576
Mailing address
116 HAMLIN AVE, EAST AURORA, NY 14052-1607
(716) 430-0576
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321020-01
NY
Other
Enumeration date
12/09/2021
Last updated
10/18/2023
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