Individual
GEORGIA MAY WIESE-MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
101 W. MCMILLAN STE 2B, MARSHFIELD, WI 54449
(715) 389-9382
(715) 389-9381
Mailing address
101 W MCMILLAN ST STE 2B, MARSHFIELD, WI 54449-1031
(715) 389-9382
(715) 389-9381
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3046-125
WI
104100000X
Social Worker
3046-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43583900
—
WI
Enumeration date
08/31/2006
Last updated
06/13/2025
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