Individual
ERICA ANN WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-2155
Mailing address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-2155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7291-26
WI
225X00000X
Occupational Therapist
—
WI
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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