Individual
MR. KIRT DON WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
387 E 450 S, CLEARFIELD, UT 84015-1734
(801) 635-5022
(801) 773-9152
Mailing address
501 W 2600 S, STE 200, BOUNTIFUL, UT 84010-7784
(801) 815-3443
(801) 776-4162
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5666130-3501
UT
Other
Enumeration date
11/25/2008
Last updated
04/22/2016
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