Individual
MRS. STEPHANIE ELIZABETH WIESMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC, LPC
Contact information
Practice address
1505 LILBURN STONE MOUNTAIN RD, SUITE 235, STONE MOUNTAIN, GA 30087-1857
(404) 387-2689
Mailing address
4024 ORCHARD HILL TER, STONE MOUNTAIN, GA 30083-1249
(404) 387-2689
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC004196
GA
Other
Enumeration date
07/14/2015
Last updated
12/12/2019
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