Individual
MALINDA JEAN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
1200 GRANT BLVD W, WABASHA, MN 55981
(651) 565-5600
(651) 565-5670
Mailing address
1200 GRANT BLVD W, WABASHA, MN 55981-1042
(651) 565-4531
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9901
MN
Other
Enumeration date
04/17/2018
Last updated
05/24/2018
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