Wieland, Lawrence
Wieland, Lawrence is an individual health care provider with primary practice located at 2950 S Alma School Rd #11, Mesa AZ 85210-4035. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wieland, Lawrence can be contacted via phone (480) 430-0169.Contact Information
Primary practice address
2950 S Alma School Rd #11
Mesa AZ 85210-4035
Phone: (480) 430-0169
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LISAC0673 | Arizona |
Profile Details
| NPI number | 1598987703 |
|---|---|
| LBN Legal business name | Wieland, Lawrence |
| Credentials | LISAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598987703 | NPPES |
| Arizona | MEDICAID | 173036 |
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