Individual
MRS. LORRAINE WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMSW
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
7171 BLUEGRASS RD, OLIVE BRANCH, MS 38654-1008
(662) 895-4630
(901) 516-8198
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW 3647
TN
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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