Individual
JENNIFER WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 NEELY FERRY ROAD, MAULDIN, SC 29662
(864) 438-0990
Mailing address
22 VISTA DR, GREENVILLE, SC 29617-8145
(864) 404-9692
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLP.6097 SPA
SC
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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