Individual
MICHELLE LEE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 871-6996
Mailing address
3520 E 48TH PL APT 3, TULSA, OK 74135-1952
(918) 871-6111
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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