Individual
SADIE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 VICTOR ST, SAINT LOUIS, MO 63104-4324
(314) 865-2799
Mailing address
1110 VICTOR ST, SAINT LOUIS, MO 63104-4324
(314) 865-2799
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2023009397
MO
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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