Individual
DEANNA JO WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
13520 ASHBURY DR, CARMEL, IN 46032-8225
(800) 900-6304
(317) 846-9484
Mailing address
3520 WILD IVY DR, INDIANAPOLIS, IN 46227-9731
(317) 633-9115
(317) 889-3150
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002134A
IN
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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