Individual
MARY WISNIESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2208 E 52ND ST, DAVENPORT, IA 52807-2726
(515) 975-8636
Mailing address
2208 E 52ND ST, DAVENPORT, IA 52807-2726
(515) 975-8636
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
095257
IA
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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