Individual
MRS. HOLLY WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
36500 WOODINGHAM ST, CLINTON TOWNSHIP, MI 48035-1688
(586) 930-2438
Mailing address
36500 WOODINGHAM ST, CLINTON TOWNSHIP, MI 48035-1688
(586) 930-2438
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
ALPP-205479
RI
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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