Mary Louise Wise is a Clinical in Mpls, Minnesota. Mary Louise Wise practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Louise Wise is 1649248550. The last update date is 2007-07-08.
Mary Louise Wise's current location address is 2 E. Franklin Ave., Mpls, Minnesota. You can contact this provider via phone number 9524518199. The mailing address for Mary Louise Wise is 2 E. Franklin Ave., Mpls, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Louise Wise |
|---|---|
| Address | 2 E. Franklin Ave., Mpls, Minnesota |
| Phone Number | 9524518199 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D., L.P |
NPI Number Detail
| NPI Number | 1649248550 |
|---|---|
| Provider Enumeration Date | 2006-03-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2 E. Franklin Ave. |
|---|---|
| City | Mpls |
| State | Minnesota (MN) |
| Post Code | 55403 |
| Phone Number | 9524518199 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP2784 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 19356WI | MN | BLUE CROSS BLUE SHIELD MN | |
| 1F233WI | MN | BCBS INDIVIDUAL # |
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What is the unique identification code assigned to Mary Louise Wise by the Centers for Medicare & Medicaid Services?
The Mary Louise Wise has been issued the NPI (National Provider Identifier) 1649248550. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Mary Louise Wise's physical address?
The Mary Louise Wise is physically located at 2 E. Franklin Ave., in the city of Mpls, MN, with the postal code 55403.
What is the area of specialization for Mary Louise Wise, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mary Louise Wise is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc0700X.
On what date did the Mary Louise Wise receive the assignment of its 1649248550 from the Centers for Medicare & Medicaid Services?
The Mary Louise Wise was issued its 1649248550 by the Centers for Medicare & Medicaid Services on 2006-03-08.
As of what date were the Mary Louise Wise's details last updated?
The information pertaining to the Mary Louise Wise, including its address, specialty, and other details, was most recently updated on 2007-07-08.
NPI Number: 1861495012
Address: 1009 North State Of Franklin Access Road, Johnson City, TN