| NPI | 1053692863 | 
|---|---|
| Other Name | LAURA MARIE WISEMAN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008106) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV 1270) | 
| Enumeration Date | 2011-09-07 | 
| Last Update Date | 2016-05-16 |