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1215259783
LETICIA WIESNER
SAN RAFAEL, CA
NPI
1215259783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-02-24
Last Update Date
2010-02-24
Business Address
-- LETICIA WIESNER
3270 KERNER BLVD
SAN RAFAEL, CA 94901-4840
Phone number: 415-457-6964
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Mailing Address
-- LETICIA WIESNER
17671 TRENTON DR
CASTRO VALLEY, CA 94546-1512
Phone number: 510-728-0361
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