Individual
JENNIFER WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(917) 744-3976
Mailing address
68 LESTER AVE, FREEPORT, NY 11520-5913
(516) 510-5439
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
1108805
NY
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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