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Organization
LOUISE WISE LLC
Active
Organization
LOUISE WISE LLC
Active
Other names
Georgia Behavioral Health Practitioner Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISE WISE (PROVIDER)
(678) 831-6429
Entity
Organization
Contact information
Practice address
2206 HANFRED LN STE 103, TUCKER, GA 30084-4809
(678) 831-6429
(687) 668-2848
Mailing address
PO BOX 309, CLARKSTON, GA 30021-0309
(678) 368-5561
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/26/2019
Last updated
04/09/2023
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