Individual
MICHAEL WIELEBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
916 BROAD ST, DURHAM, NC 27705-4142
(919) 452-1012
Mailing address
7125 CALAIS DR, DURHAM, NC 27712-9653
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
3157
NC
Other
Enumeration date
10/24/2010
Last updated
10/24/2010
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