| Doctor Name: | LESLEY ANDREWS-WISE |
| NPI Number: | 1144687294 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 90264 |
| Business Practice Address: | 354 S Halcyon Rd Arroyo Grande, CA - 934203876 |
| Business Phone Number: | 8054737060 |
| Business Fax Number: | 8054737124 |
| Mailing Address: | 354 S Halcyon Rd, ARROYO GRANDE |
| State: | CA |
| Postal Code: | 934203876 |
| Phone Number: | 8054737060 |
| Fax Number: | 8054737124 |
| NPI Enumeration Date: | 01/20/2016 |
| NPI Last Update Date: | 01/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 90264 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |