Individual
MS. WENDY MICHELLE WISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
4714 217TH ST, 2A, BAYSIDE, NY 11361-3501
(718) 224-1433
Mailing address
4714 217TH ST, 2A, BAYSIDE, NY 11361-3501
(718) 224-1433
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11295549
NY
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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