Individual
DR. SARA E WISE
Active
Individual
DR. SARA E WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
105860
IA
103TA0700X
Adult Development & Aging Psychologist
105860
IA
103TB0200X
Cognitive & Behavioral Psychologist
105860
IA
103TC0700X
Clinical Psychologist
Primary
105860
IA
103TC1900X
Counseling Psychologist
105860
IA
103TC2200X
Clinical Child & Adolescent Psychologist
105860
IA
103TF0000X
Family Psychologist
105860
IA
103TH0100X
Health Service Psychologist
105860
IA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
105860
IA
103TP2701X
Group Psychotherapy Psychologist
105860
IA
103TS0200X
School Psychologist
105860
IA
Other
Enumeration date
10/05/2020
Last updated
11/09/2021
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