Individual
BRENDA GAIL WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
355 BURN HILL RD, SHERMANS DALE, PA 17090-8905
(315) 286-6569
Mailing address
355 BURN HILL RD, SHERMANS DALE, PA 17090-8905
(315) 286-6569
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC007958
PA
Other
Enumeration date
02/19/2020
Last updated
02/23/2021
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