Individual
BIANCA M. WISDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 SHERMAN ST, BRENTWOOD, NY 11717-2735
(631) 504-2310
Mailing address
206 SHERMAN ST, BRENTWOOD, NY 11717-2735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
016957
NY
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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