Individual
DR. MARCIE C WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2704 N OAK ST, BUILDING B-3, VALDOSTA, GA 31602-1744
(229) 257-0100
Mailing address
2704 N OAK ST, BUILDING B-3, VALDOSTA, GA 31602-1744
(229) 257-0100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003561
GA
Other
Enumeration date
12/03/2009
Last updated
11/08/2012
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