Provider Demographics
NPI:1689887002
Name:WEISIGER, MARIAN VICTORIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:VICTORIA
Last Name:WEISIGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 JEFFERSON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-4031
Mailing Address - Country:US
Mailing Address - Phone:304-232-3388
Mailing Address - Fax:304-325-6956
Practice Address - Street 1:1809 JEFFERSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-4031
Practice Address - Country:US
Practice Address - Phone:304-232-3388
Practice Address - Fax:304-325-6956
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional