Provider Demographics
NPI:1164135232
Name:WIEGERT, DANIEL (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:WIEGERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 PALISADES PARK DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1344
Mailing Address - Country:US
Mailing Address - Phone:540-287-6161
Mailing Address - Fax:
Practice Address - Street 1:1643 24TH ST W STE 103
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2677
Practice Address - Country:US
Practice Address - Phone:406-662-8802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling