Individual
BETH WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9715 HEALTHWAY DR, BERLIN, MD 21811-3500
(410) 629-6148
Mailing address
9715 HEALTHWAY DR, BERLIN, MD 21811-3500
(410) 629-6148
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
T00269
MD
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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