Basic Information
| Provider Information | |||||||||
| NPI: | 1487970877 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WUELFING | ||||||||
| FirstName: | NEDDINE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MA, LPC, QMHP, CAADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 E CEDAR AVE | ||||||||
| Address2: | |||||||||
| City: | GLADWIN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486242215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894269295 | ||||||||
| FaxNumber: | 9894262251 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 E CEDAR AVE | ||||||||
| Address2: | |||||||||
| City: | GLADWIN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486242215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894269295 | ||||||||
| FaxNumber: | 9894262251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2010 | ||||||||
| LastUpdateDate: | 05/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6401011839 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.