Individual
TEGAN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
23 E CONESTOGA RD, ELVERSON, PA 19520-9413
(610) 608-9747
Mailing address
23 E CONESTOGA RD, ELVERSON, PA 19520-9413
(610) 608-9747
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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