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Individual

CAROLYN POWERS WIERSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
US HIGHWAY 191 & HOSPITAL ROAD, CHINLE, AZ 86503
(864) 884-7879
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(864) 884-7879

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD463873
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/15/2015
Last updated
10/02/2020
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