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Individual

LORI ETTA WISOTZKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCHW, CRS,CFRS

Contact information

Practice address
5375 BOARD RD, MOUNT WOLF, PA 17347-9565
(717) 660-3571
Mailing address
5375 BOARD RD, MOUNT WOLF, PA 17347-9565
(717) 660-3571

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
50284
PA
175T00000X
Peer Specialist
20584
PA
175T00000X
Peer Specialist
50284
PA
374J00000X
Doula

Other

Enumeration date
08/05/2024
Last updated
03/21/2026
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