Individual
MS. ELIZABETH WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
4102 E PARHAM RD, HENRICO, VA 23228-2743
(804) 672-8588
(804) 672-8587
Mailing address
4102 E PARHAM RD, HENRICO, VA 23228-2743
(804) 672-8588
(804) 672-8587
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004050
VA
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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