Mark Wise PSY.D.

NPI 1477645471 - Psychologist - 103TC0700X

NPI Details
NPI 1477645471
Gender Male
Enumeration Date 09/28/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3000 SCHATULGA RD BLDG 5
COLUMBUS GA, 31907-3117, US
Phone (706) 568-5216
Fax (706) 562-1484
Business Location
4989 POST ROAD PASS
STONE MOUNTAIN GA, 30088-2007, US
Phone (770) 469-6754
Fax (770) 498-4738
Toxanomy
Taxonomy Code 103TC0700X
License State Georgia
License Number PSY000818
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According to our database, Dr. Mark Wise PSY.D. NPI is 1477645471, taxonomy code is 103TC0700X and license number is PSY000818, license state is located at Georgia. Mark Wise PSY.D. physically located at 3000 Schatulga Rd Bldg 5, Columbus GA, 31907-3117. NPI Number Mark Wise PSY.D. has the Individual type.

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1477645471 NPI number is provided on an as is basis without warranty of any kind. 1477645471 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Wise PSY.D. are for informational purposes only.