Individual
CARLY D WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ED. S.
Contact information
Practice address
119 MAIN ST, CLAYSVILLE, PA 15323-2396
(724) 665-5364
(724) 663-3696
Mailing address
119 MAIN STREET, PO BOX 421, CLAYSVILLE, PA 15301
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2539197
PA
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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