Individual
CHLOE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 CADUCEUS WAY BUILDING 600 - SUITE 101., WATKINSVILLE, GA 30677
(866) 610-0580
Mailing address
120 NUNNALLY RD SE, WINDER, GA 30680-4240
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
DON'T CURRENTLY HAVE HEALTH INSURANCE
—
Enumeration date
10/14/2020
Last updated
10/14/2020
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