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Individual
MRS. ELIZABETH L. WISE
Active
Individual
MRS. ELIZABETH L. WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99104
CA
1041C0700X
Clinical Social Worker
75984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255833125
OTHER
CA
05
—
75984
—
CA
Enumeration date
03/06/2018
Last updated
09/17/2021
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