Individual provider · Type 1 NPI
Leticia Wiesner
Mental Health Counselor · San Rafael, CA
NPI number
1215259783
Active
Practice location
3270 Kerner Blvd
San Rafael, CA 94901-4840
Fax (415) 456-1508
Mailing address
17671 Trenton Dr
Castro Valley, CA 94546-1512
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1215259783
Leticia Wiesner's National Provider Identifier is 1215259783, issued on Feb 24, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Rafael, CA. The record was last updated on Feb 24, 2010.