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General NPI Number Information
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NPI Number | 1407655608
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Entity Type | Individual
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Provider Name | LEIGH A. WIESEHAN MS, LPC-A
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 6041 WT MONTGOMERY
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City | SAN ANTONIO
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State | TX
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Zip | 78252-2234
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Country | US
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Telephone | 210-646-4202
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Fax |
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Provider Business Mailing Address
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Address Line | 8702 VILLAGE DR APT 1303
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5408
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Country | US
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Telephone | 210-621-4231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 94712
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License Number State | TX
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