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Individual

MRS. ROCHELLE DAWN WISEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MACCCSLP

Contact information

Practice address
2850 5TH AVE, HUNTINGTON, WV 25702-1436
(304) 528-5000
Mailing address
18 PARADISE LN, ONA, WV 25545-9201
(304) 528-5000

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0698
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810013169
WV
Enumeration date
10/13/2008
Last updated
10/13/2008
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