Wiertzema, Timothy Del

Wiertzema, Timothy Del is an individual health care provider with primary practice located at 8669 Eagle Point Blvd , Lake Elmo MN 55042-8628. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Wiertzema, Timothy Del can be contacted via phone (651) 379-0444.

Contact Information

Primary practice address
8669 Eagle Point Blvd Lake Elmo MN 55042-8628
Phone: (651) 379-0444
Fax: (651) 379-0448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 2142 Minnesota

Profile Details

NPI number 1164722005
LBN Legal business name Wiertzema, Timothy Del
Credentials M.A., LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2010
Last updated Dec 23rd, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164722005 NPPES
Minnesota MEDICAID 1164722005

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