Wiedel, Timothy C.

Wiedel, Timothy C. is an sole proprietor health care provider with primary practice located at 7251 W North Ave Suite 5, Wauwatosa WI 53213-1851. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wiedel, Timothy C. can be contacted via phone (414) 248-2554.

Contact Information

Primary practice address
7251 W North Ave Suite 5 Wauwatosa WI 53213-1851
Phone: (414) 248-2554
Fax: (414) 302-4620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 1227-057 Wisconsin
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1227-057 Wisconsin
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 1227-057 Wisconsin

Profile Details

NPI number 1033208319
LBN Legal business name Wiedel, Timothy C.
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Jan 20th, 2012 - 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 1033208319 NPPES
Wisconsin MEDICAID 39071000

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