Individual
MS. ANDREA WIESELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC
Contact information
Practice address
9835 MANCHESTER ROAD, ST LOUIS, MO 63119
(314) 968-4710
(314) 968-4762
Mailing address
9835 MANCHESTER ROAD, ST LOUIS, MO 63119
(314) 968-4710
(314) 968-4762
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01788
MO
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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