Individual
JULIET LATANYA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2700 FAIRBANKS ST NW, HUNTSVILLE, AL 35816-2432
(256) 281-1737
Mailing address
4607 GRIZZARD RD NW, HUNTSVILLE, AL 35810-3640
(256) 658-3457
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1325-3911C
AL
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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