Organization
WISE PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN MARIE O'DWYER LCSW (OWNER/THERAPIST)
(248) 891-6946
Entity
Organization
Contact information
Practice address
480 GRACE AVE, ROCHESTER HILLS, MI 48307-5102
(248) 891-6946
Mailing address
26669 SPICER ST, MADISON HEIGHTS, MI 48071-3853
(248) 891-6946
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447672191
NPI
MI
Enumeration date
05/14/2021
Last updated
05/14/2021
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