Healthcare Provider Details

I. General information

NPI: 1942146436
Provider Name (Legal Business Name): MRS. SHANNON WEISSLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 SLABTOWN RD
LIMA OH
45801-3309
US

IV. Provider business mailing address

190 HILLCREST DR
BLUFFTON OH
45817-1131
US

V. Phone/Fax

Practice location:
  • Phone: 419-222-1836
  • Fax:
Mailing address:
  • Phone: 419-306-4758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.00235
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: