Individual
BRIAN WISE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
300 W 19TH TER, KANSAS CITY, MO 64108-2026
(816) 404-5720
Mailing address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-5720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011027078
MO
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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