Individual
CAROL LEWIS WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1463 OAKFIELD DR STE 102, BRANDON, FL 33511-3893
(813) 655-4166
Mailing address
4577 COUNTRY MANOR DR, SARASOTA, FL 34233-1869
(781) 424-0161
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
19406
FL
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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