Individual
ELIZABETH WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH ASSISTANT
Contact information
Practice address
1410 POST OAK RD, MOUNTAIN HOME, AR 72653-5516
(870) 424-0187
Mailing address
PO BOX 610, VALLEY SPRINGS, AR 72682-0610
(870) 429-9127
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05-0077
—
AR
Enumeration date
09/18/2009
Last updated
09/18/2009
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