Individual
KATIE A WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CD, ERYT, CYPT
Contact information
Practice address
737 29TH ST, BOULDER, CO 80303-2317
(303) 815-5284
Mailing address
737 29TH ST, BOULDER, CO 80303-2317
(303) 815-5284
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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