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General NPI Number Information
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NPI Number | 1992715189
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Entity Type | Individual
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Provider Name | CAROL J WESLEY MS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 2600 STEWART AVE SUITE 38
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City | WAUSAU
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State | WI
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Zip | 54401-4148
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Country | US
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Telephone | 715-845-4900
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Fax | 715-845-4970
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Provider Business Mailing Address
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Address Line | 3302 MAPLE HILL DR
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City | WAUSAU
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State | WI
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Zip | 54401-3767
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Country | US
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Telephone | 715-845-4900
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Fax | 715-845-4970
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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 | 443-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 540-124
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License Number State | WI
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