Individual
ERIC GERARD WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
20 MARKET STREET, SUITE 230, LOCKPORT, NY 14094
(716) 625-9550
(716) 433-7846
Mailing address
20 MARKET STREET, SUITE 230, LOCKPORT, NY 14094
(716) 625-9550
(716) 433-7846
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013711
NY
Other
Enumeration date
09/19/2006
Last updated
07/08/2007
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