Individual
LI WIESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4010 CENTRAL AVE, SAINT PETERSBURG, FL 33711-1239
(727) 900-1326
(727) 256-0039
Mailing address
6306 S MACDILL AVE APT 804, TAMPA, FL 33611-5049
(727) 900-1326
(727) 256-0039
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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