Individual
MONIQUE MACHELLE WISNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1008 4TH AVE SE APT 116, WATFORD CITY, ND 58854-7732
(701) 566-9020
Mailing address
1008 4TH AVE SE APT 116, WATFORD CITY, ND 58854-7732
(701) 566-9020
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3648
ND
171M00000X
Case Manager/Care Coordinator
Primary
45600224
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460241
—
ND
Enumeration date
06/24/2016
Last updated
12/10/2020
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