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Individual

MRS. KAHTLEEN BETH WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
8702 SW 122ND ST, GAINESVILLE, FL 32608-5740
(352) 495-6261
Mailing address
8702 SW 122ND ST, GAINESVILLE, FL 32608-5740
(352) 495-6261

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
04/20/2007
Last updated
04/06/2012
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