Individual
MS. CAROLYN DENISE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRW
Contact information
Practice address
1446 ETHAN WAY, SACRAMENTO, CA 95825-2214
(916) 922-5110
(916) 921-1239
Mailing address
1446 ETHAN WAY, SACRAMENTO, CA 95825-2214
(916) 922-5110
(916) 921-1239
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/23/2009
Last updated
02/03/2014
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