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Individual

DR. DENISE KAY WISWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
301 S CRAPO ST, MT PLEASANT, MI 48858-2941
(989) 772-5938
Mailing address
901 HOPKINS AVE, MT PLEASANT, MI 48858-3330
(989) 317-3717

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301010069
MI
1041C0700X
Clinical Social Worker
6801018098
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
U002 898470
DESERET MUTUAL
UT
01
U003 942938348DEW
EDUCATORS MUTUAL
UT
01
U006 107001882102
INTERMOUNTAIN HEALTH CARE
UT
Enumeration date
12/20/2005
Last updated
05/16/2013
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