Individual
GABRIELL LUCILLE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2660 W HUME RD, LIMA, OH 45806-9446
(574) 721-2436
Mailing address
2660 W HUME RD, LIMA, OH 45806-9446
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.2208229
OH
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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