Provider Demographics
NPI:1689316689
Name:WIEBER, KARA ELIZABETH
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:ELIZABETH
Last Name:WIEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 N RIDGE RD E STE C
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3360
Mailing Address - Country:US
Mailing Address - Phone:440-723-5504
Mailing Address - Fax:
Practice Address - Street 1:1865 N RIDGE RD E STE C
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3360
Practice Address - Country:US
Practice Address - Phone:440-723-5504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator