Wiese, Steven Roger

Wiese, Steven Roger is an individual health care provider with primary practice located at 2780 Snelling Ave N Ste 104 , Roseville MN 55113-7115. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Wiese, Steven Roger can be contacted via phone (651) 633-5290.

Contact Information

Primary practice address
2780 Snelling Ave N Ste 104 Roseville MN 55113-7115
Phone: (651) 633-5290
Fax: (651) 633-5238
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP1426 Minnesota

Profile Details

NPI number 1194941682
LBN Legal business name Wiese, Steven Roger
Credentials L.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194941682 NPPES
Minnesota Other 04Q65WI BCBSM NON PAR PROVIDER ID

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