Theodore Scott Wiebold
NPI #1982192381 in Burnsville, Minnesota
Provider Information
- NPI Number
- 1982192381
- Entity Type
- Individual
- Name
- Theodore Scott Wiebold
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- May 1, 2018
- Last Updated
- May 1, 2018
Practice Location
- Address
- 14301 EWING AVE S
- City
- Burnsville
- State
- Minnesota
- ZIP Code
- 55306-4885
- Phone
- (952) 746-5350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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