Individual
MRS. MYSTIE-DAWN RAYMOND WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNMT
Contact information
Practice address
3955 E EXPOSITION AVE, STE. #320, DENVER, CO 80209-5000
(303) 777-1151
(303) 777-3112
Mailing address
5589 S CURTICE ST, LITTLETON, CO 80120-1105
(303) 795-4379
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7836
CO
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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