Individual
JENNIFER WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS, LADC
Contact information
Practice address
545 7TH ST W, SAINT PAUL, MN 55102-3007
(612) 286-1120
Mailing address
545 7TH ST W, SAINT PAUL, MN 55102-3007
(612) 286-1120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MN
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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