Individual
EMILY GRACE WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
7777 E US HIGHWAY 66, EL RENO, OK 73036-9125
(405) 424-7711
Mailing address
12272 SW 11TH ST, YUKON, OK 73099-7024
(405) 630-8101
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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