Individual
CAROL ANN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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