Organization
WIND & WAVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY D WEISS (CLINICIAN/THERAPIST)
(574) 327-6633
Entity
Organization
Contact information
Practice address
1750 KILBOURN ST, ELKHART, IN 46514-1920
(574) 327-6633
Mailing address
1750 KILBOURN ST, ELKHART, IN 46514-1920
(574) 327-6633
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811167463
—
IN
Enumeration date
01/02/2019
Last updated
01/28/2019
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