Individual
MELISSA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3115 SUNSET BLVD, WEST COLUMBIA, SC 29169-3425
(803) 791-3722
(803) 905-4431
Mailing address
181 W PROFESSIONAL PARK CT, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26871
SC
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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