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Individual

JOHN WIEGLENDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
24 W VILLARD ST STE B, DICKINSON, ND 58601
(701) 483-0795
(701) 483-0947
Mailing address
24 W VILLARD ST STE B, DICKINSON, ND 58601-5152
(701) 483-0795
(701) 483-0947

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1353
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11608
BCBS
ND
05
1473810
ND
Enumeration date
03/30/2007
Last updated
06/18/2018
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