Individual
PATRICIA H WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2942 EVERGREEN PKWY, SUITE 302, EVERGREEN, CO 80439-7909
(303) 679-6106
(303) 674-6695
Mailing address
PO BOX 3506, EVERGREEN, CO 80437-3506
(303) 679-6106
(303) 674-6695
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
989525
CO
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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