Organization
JUDY KAYE WIEBERG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY KAYE WIEBERG LCPC (COUNSELOR)
(775) 848-7674
Entity
Organization
Contact information
Practice address
2105 CAPURRO WAY, SUITE 105, SPARKS, NV 89431-8518
(775) 848-7674
Mailing address
11040 HEARTPINE ST, RENO, NV 89506-8952
(775) 848-7674
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CPOO21
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
1089-L
NV
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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