# JACQUELYN N WISE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1215757208
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | — | — |
| 133N00000X | Nutritionist | — | — | — |
| 172A00000X | Driver | — | — | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | — | — |
| 251X00000X | Supports Brokerage Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | — |
| 261QA0600X | Adult Day Care Clinic/Center | — | — | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | — | — |
| 347C00000X | Private Vehicle | — | — | — |
| 372600000X | Adult Companion | — | — | — |
| 374U00000X | Home Health Aide | — | — | — |
| 376J00000X | Homemaker | — | — | Yes |
| 385HR2055X | Child Mental Illness Respite Care | — | — | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | — | — |

## Other

- **Enumeration date:** 10/14/2024
- **Last updated:** 10/14/2024