Madison Mae Wiese is a Peer Specialist based in Jay, OK. Madison Mae Wiese practices in Jay, OK. The NPI Number for Madison Mae Wiese is 1457065963 and holds a License No. (Oklahoma).
The current practice location address for Madison Mae Wiese is 1015 W Washbourne St, Jay, OK and can be reached out via phone at 844-458-2100.
Location: 1015 W Washbourne St, Jay, OK, 74346-4205
Provider Profile Details
NPI Number
1457065963
Provider Name
Madison Mae Wiese
Credential
Provider Entity Type
Individual
Gender
Female
Address
1015 W Washbourne St, Jay, OK, 74346-4205
Phone Number
844-458-2100
Fax Number
Provider Enumeration Date
01/09/2023
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
1015 W Washbourne St
City
State
Zip
74346-4205
Phone Number
844-458-2100
Fax Number
Provider Business Mailing Address Details
Address
1015 W Washbourne St
City
State
Zip
74346-4205
Phone Number
844-458-2100
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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