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General NPI Number Information
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NPI Number | 1356940969
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Entity Type | Organization
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Legal Business Name | MICKI R WIERMAN PHD PLLC
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 102 N MICHIGAN AVE
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City | HOWELL
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State | MI
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Zip | 48843-2202
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Country | US
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Telephone | 248-531-8381
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Fax |
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Provider Business Mailing Address
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Address Line | 102 N MICHIGAN AVE
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City | HOWELL
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State | MI
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Zip | 48843-2202
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Country | US
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Telephone | 248-531-8381
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICKI WIERMAN
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Credential |
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Telephone | 248-531-8381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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