Individual
ELEANOR RENEE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAS
Contact information
Practice address
4525 S SANDHILL RD STE 103, LAS VEGAS, NV 89121-5955
(702) 741-1938
(702) 778-5283
Mailing address
3950 TIMBERLAKE DRIVE, LAS VEGAS, NV 89115
(919) 696-5857
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/06/2007
Last updated
12/13/2016
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