Individual
KAYLE A WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
800 N FRONT ST STE 15, WATERLOO, NE 68069-2250
(402) 669-3197
Mailing address
800 N FRONT ST STE 15, WATERLOO, NE 68069-2250
(402) 669-3197
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
81878
NE
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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