Individual
ELENA WIESNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LBS, BCBA
Contact information
Practice address
60 N 8TH ST, LEWISBURG, PA 17837-1446
(570) 523-1297
Mailing address
60 N 8TH ST, LEWISBURG, PA 17837-1446
(570) 523-1297
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22072
PA
Other
Enumeration date
01/19/2017
Last updated
04/30/2019
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