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General NPI Number Information
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NPI Number | 1871403212
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Entity Type | Individual
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Provider Name | MICAH WIEGAND
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Gender |
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 4141 HULL RD
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City | LESLIE
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State | MI
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Zip | 49251-9578
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Country | US
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Telephone | 517-589-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 4141 HULL RD
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City | LESLIE
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State | MI
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Zip | 49251-9578
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Country | US
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Telephone |
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Fax |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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