Individual
DEREK WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCPC
Contact information
Practice address
5510 S FORT APACHE RD, LAS VEGAS, NV 89148-7700
(702) 604-2498
Mailing address
5510 S FORT APACHE RD, LAS VEGAS, NV 89148-7700
(702) 604-2498
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CP1204
NV
Other
Enumeration date
05/30/2014
Last updated
05/31/2025
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