Individual
MS. DEANNE E WIENTGE
Active
Individual
MS. DEANNE E WIENTGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2004024130
MO
1041C0700X
Clinical Social Worker
Primary
LW60109860
WA
1041S0200X
School Social Worker
1600924
IL
Other
Enumeration date
12/17/2009
Last updated
01/18/2016
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