Individual
LESLIE A WISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1555 TEA PARTY LN, O FALLON, MO 63366-5519
(314) 458-3836
Mailing address
1555 TEA PARTY LN, O FALLON, MO 63366-5519
(314) 458-3836
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2010017636
MO
Other
Enumeration date
07/06/2010
Last updated
10/09/2025
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