Individual
EDITH ELIZABETH WISE-ANDREWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RTC
Contact information
Practice address
860 N BUSH ST, UKIAH, CA 95482-3919
(707) 463-4303
Mailing address
2001 MCCLURE SUBDIVISION RD, UKIAH, CA 95482-6113
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225800000X
Recreation Therapist
Primary
2660-T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2660-T
RECREATION THERAPY CERTIF
CA
Enumeration date
01/08/2007
Last updated
09/11/2025
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