Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 01780 | MN |
NPI | 1003281536 |
---|---|
Provider Name | Heather Leann Wegner |
First Address | Germantown, WI 53022-6511 |
Second Address | Lakeville, MN 55044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2015 |
Last Update Date | 03/07/2018 |