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1427290501
MARY LOU WISE
OREM, UT
NPI
1427290501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 134492-3501)
Enumeration Date
2009-04-03
Last Update Date
2009-04-03
Business Address
-- MARY LOU WISE LCSW
1790 N STATE ST
OREM, UT 84057-2025
Phone number: 801-224-8255
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Mailing Address
-- MARY LOU WISE LCSW
1790 N STATE ST
OREM, UT 84057-2025
Phone number: 801-224-8255
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