Individual
KATHERINE WISEHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
185 STARGAZER DR, SMITH RIVER, CA 95567-9390
(386) 576-6894
Mailing address
185 STARGAZER DR, SMITH RIVER, CA 95567-9390
(386) 576-6894
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
214170
TX
224Z00000X
Occupational Therapy Assistant
Primary
363662
OR
Other
Enumeration date
09/19/2016
Last updated
08/07/2021
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