Individual
REBECA WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
1801 N 98TH ST, KANSAS CITY, KS 66111-1869
(913) 264-3000
(913) 264-9940
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3758
KS
Other
Enumeration date
08/24/2015
Last updated
06/19/2018
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