Individual
MRS. MARISA WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5550 W FLAMINGO RD STE C5, LAS VEGAS, NV 89103-0137
(702) 816-7059
Mailing address
2570 OFANTO ST, HENDERSON, NV 89044-1798
(702) 816-7059
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0313
NV
Other
Enumeration date
03/21/2017
Last updated
07/28/2024
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