Individual
DR. SHANE M WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
8401 CONNECTICUT AVE STE 1120, CHEVY CHASE, MD 20815-5846
(301) 593-6554
Mailing address
8401 CONNECTICUT AVE STE 1120, CHEVY CHASE, MD 20815-5846
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
07345
MD
Other
Enumeration date
08/21/2024
Last updated
06/19/2025
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