Individual
CHERYL L WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 CRESTBROOK CT, PROSPECT, KY 40059-8142
(502) 773-8483
Mailing address
3200 CRESTBROOK CT, PROSPECT, KY 40059-8142
(502) 773-8483
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
283787
KY
Other
Enumeration date
11/13/2019
Last updated
11/02/2023
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