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1164696597
SHANNON MARIE WISEMAN
SANTA ROSA, CA
NPI
1164696597
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-04-16
Last Update Date
2009-09-01
Business Address
-- SHANNON MARIE WISEMAN
3164 CONDO CT
SANTA ROSA, CA 95403-2557
Phone number: 707-523-2334
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Mailing Address
-- SHANNON MARIE WISEMAN
341 IRWIN LN
SANTA ROSA, CA 95401-5603
Phone number: 707-576-7218
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