Individual
DR. JENNIFER DIANNE WIENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Mailing address
1120 E KENNEDY BLVD UNIT 1019, TAMPA, FL 33602-3587
(813) 336-9244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
PY10631
FL
Other
Enumeration date
08/27/2015
Last updated
06/09/2022
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