Individual
DR. MARK STEPHEN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 E PIEDMONT RD STE 202, MARIETTA, GA 30062-7758
(470) 435-1547
Mailing address
2501 E PIEDMONT RD STE 202, MARIETTA, GA 30062-7758
(470) 435-1547
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
LPC014257
GA
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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