Individual
MRS. JAMIE MARIE WIESNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0588
SD
225X00000X
Occupational Therapist
103448
MN
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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