Individual
CHRISTA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 E STREETER AVE, MUNCIE, IN 47303-1909
(765) 284-4166
(765) 287-9547
Mailing address
114 E STREETER AVE, MUNCIE, IN 47303-1909
(765) 284-4166
(765) 287-9547
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003465A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22003465A
SPEECH PATHOLOGIS LICENSE
IN
Enumeration date
11/24/2008
Last updated
11/24/2008
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