Individual
DANA WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
108 SUE LN, DANIELS, WV 25832-9577
(973) 216-5852
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00945701
WV
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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