Individual
MARGUERITE KAY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
205 E WASHINGTON CENTER RD, FORT WAYNE, IN 46825-4404
(260) 482-2586
(260) 471-5949
Mailing address
205 E WASHINGTON CENTER RD, FORT WAYNE, IN 46825-4404
(260) 482-2586
(260) 471-5949
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
35000653A
IN
101YM0800X
Mental Health Counselor
Primary
35000653A
IN
104100000X
Social Worker
33000819A
IN
106H00000X
Marriage & Family Therapist
35000653A
IN
Other
Enumeration date
07/26/2006
Last updated
07/03/2013
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