Individual
MONIQUE WISCHUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3198 SHADOW WALK LN, TUCKER, GA 30084-2141
(504) 214-9898
Mailing address
3198 SHADOW WALK LN, TUCKER, GA 30084-2141
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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