Individual
AWHAWANNA WENONA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 W PLEASANT RUN RD, CEDAR HILL, TX 75104-5402
(972) 291-5977
Mailing address
224 W PLEASANT RUN RD, CEDAR HILL, TX 75104-5402
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213609
TX
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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