Individual
MRS. KATHERINE SUE WISEHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC
Contact information
Practice address
105 EAST LAFAYETTE, MONTICELLO, MO 63457
(573) 767-1212
(573) 767-1212
Mailing address
22110 STATE HIGHWAY 6, EWING, MO 63440-2629
(573) 767-1212
(573) 767-1212
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MO
Other
Enumeration date
10/24/2012
Last updated
08/25/2021
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