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Individual

MR. CHARLES AFTON WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA LMHC

Contact information

Practice address
1491 EAST SR 434, SUITE 104, WINTER SPRINGS, FL 32708
(407) 366-5656
(407) 386-6658
Mailing address
1054 GOULD PLACE, OVIEDO, FL 32765
(407) 366-5656
(407) 386-6658

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH3981
FL

Other

Enumeration date
09/15/2014
Last updated
09/15/2014
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