| Organization Name: | VIERA PSYCHOLOGICAL SERVICES PA |
| NPI Number: | 1306928973 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON WIESELER (OWNER) |
| Mailing Address: | 345 6th Ave Indialantic |
| State: | FL US |
| Postal Code: | 329034301 |
| Phone Number: | 3219512100 |
| Fax Number: | 3219511204 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 03/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY7276 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |