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1073800108
KELLY JEAN WISE
BROOKLYN, NY
NPI
1073800108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 73-07699)
Enumeration Date
2011-07-10
Last Update Date
2017-03-14
Business Address
-- KELLY JEAN WISE LCSW
60 PLAZA ST E SUITE 1G
BROOKLYN, NY 11238-5025
Phone number: 917-822-5045
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Mailing Address
-- KELLY JEAN WISE LCSW
60 PLAZA ST E 1G
BROOKLYN, NY 11238-5025
Phone number: 917-822-5045
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