Individual
GLORIA ALICIA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
812 W TOWN AND COUNTRY RD, ORANGE, CA 92868-4712
(714) 547-6494
Mailing address
24 FLORENTINE, ALISO VIEJO, CA 92656-4229
(949) 610-3927
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/31/2012
Last updated
03/28/2013
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