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NPI Profile for JOANNA E WIESE in MOUNTAIN HOME AFB, ID.
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prescribing (Medical) |
103TP0016X | 62 | Psychologist, Clinical |
| NPI # | 1063711869 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/18/2011 | |
| Last updated | 10/16/2025 - About 8 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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JOANNA E WIESE
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JOANNA E WIESE