Andrea Wieselman, MS CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01788 Issued in MO

Practice address

9835 Manchester Road
St Louis, MO 63119

Phone

(314) 968-4710

Fax

(314) 968-4762

NPI assigned

Mar 28, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Easter Seals Midwest

  • Behavior Analyst
  • Saint Louis, MO
  • NPI 1871625582

  Speech-Language Pathologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1386816494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9835 MANCHESTER ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63119",
            "telephone_number": "314-968-4710",
            "fax_number": "314-968-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9835 MANCHESTER ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63119",
            "telephone_number": "314-968-4710",
            "fax_number": "314-968-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESELMAN",
        "first_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "MS CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "01788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Wiese, LCSW
• Barry Wiese, D.C.
• Jessica Deyton Wiese, CRNA
• Jonathan Richard Wiese, AGNP
• Holly J Wiesehan, ACNP
• Arthur Stuart Wieselthier, DMD
• Erin Kathleen Wiesner, PA
• Wiethop Chiropractic, LLC
• Justin Wiethop, D.C.
• Kelli P Wiethuchter, FNP

• Speech-Language Pathologist in St Louis, MO
• Providers in St Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.