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Individual

MR. JOHN A WIEDERSPAHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CMHW

Contact information

Practice address
1901 CENTRAL AVE, CHEYENNE, WY 82001-3759
(307) 638-4092
(307) 433-8785
Mailing address
1121 LUCKY CT, CHEYENNE, WY 82001-6100
(307) 286-1733
(307) 433-8785

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMHW-28
WY

Other

Enumeration date
05/01/2007
Last updated
07/08/2007
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