Individual
AUTUMN WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 N SAINT JOSEPH AVE STE C2, NILES, MI 49120-2263
(269) 262-1815
Mailing address
24 N SAINT JOSEPH AVE STE C2, NILES, MI 49120-2263
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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