Individual
PAMELA LAWSON WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 HOLIDAY BLVD, MERRITT ISLAND, FL 32952-5537
(049) 414-5927
Mailing address
1460 HOLIDAY BLVD, MERRITT ISLAND, FL 32952-5537
(704) 941-4592
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/03/2014
Last updated
04/22/2022
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