Individual
JAYCIE WISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 COMPANION CT, SUMTER, SC 29150-1749
(803) 905-5107
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 695-2277
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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