Individual
MRS. MICHELLE RENE WIESNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP
Contact information
Practice address
3951 STORM CLOUD WAY, CASTLE ROCK, CO 80104-7855
(303) 963-5713
Mailing address
3951 STORM CLOUD WAY, CASTLE ROCK, CO 80104-7855
(303) 963-5713
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
CO
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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