# WISE MIND AND BODY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wise Mind and Body, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417721630
- **Authorized official:** MS. JOANNA WISEMAN NP (CEO/OWNER)
- **Authorized official phone:** (631) 512-9807

## Contact information

- **Practice address:** 142 NIMS SPRING DR, FORT MILL, SC 29715-6461
- **Practice address phone:** (631) 512-9807
- **Mailing address:** 142 NIMS SPRING DR, FORT MILL, SC 29715-6461
- **Mailing address phone:** (631) 512-9807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2023
- **Last updated:** 11/13/2023