Doctor Name: | CHRISTOPHER J WIEGENSTEIN |
NPI Number: | 1033512744 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2637 |
Business Practice Address: | 26 4th St N Great Falls, MT - 594013106 |
Business Phone Number: | 4067272512 |
Business Fax Number: | 4067277451 |
Mailing Address: | Po Box 3126, GREAT FALLS |
State: | MT |
Postal Code: | 594033126 |
Phone Number: | 4067272512 |
Fax Number: | 4067277451 |
NPI Enumeration Date: | 10/08/2014 |
NPI Last Update Date: | 10/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 2637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |