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General NPI Number Information
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NPI Number | 1558615898
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Entity Type | Individual
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Provider Name | SUSAN K WEIGEL-WISE LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 1600 N LORRAINE ST 202
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City | HUTCHINSON
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State | KS
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Zip | 67501-5670
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Country | US
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Telephone | 620-663-7595
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Fax | 620-663-5263
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Provider Business Mailing Address
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Address Line | 108 W 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-3624
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Country | US
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Telephone | 620-200-5775
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Fax | 620-663-5263
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8658
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License Number State | KS
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