Individual
MANDIE LEIGH WIANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8201 S CROW CUTOFF, PUEBLO, CO 81004-9704
(719) 568-0713
Mailing address
720 N MAIN ST, PUEBLO, CO 81003-3020
(719) 470-0320
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
11/15/2023
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