| Doctor Name: | HEATHER LEANN WEGNER |
| NPI Number: | 1003281536 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC |
| License Number: | 01780 |
| Business Practice Address: | 19950 Dodd Blvd Suite 102 Lakeville, MN - 550446341 |
| Business Phone Number: | 8004381772 |
| Business Fax Number: | 2622939737 |
| Mailing Address: | W175n11120 Stonewood Dr, GERMANTOWN |
| State: | WI |
| Postal Code: | 530226511 |
| Phone Number: | 8004381772 |
| Fax Number: | 2622939737 |
| NPI Enumeration Date: | 12/09/2015 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 01780 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |