Individual
MALIYAH RENAE WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
Mailing address
11342 GREAT COMMISSION WAY, ORLANDO, FL 32832-7066
(321) 591-8564
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
8121
FL
2355S0801X
Speech-Language Assistant
—
FL
Other
Enumeration date
07/14/2025
Last updated
08/01/2025
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