Victoria Lauren Wise

NPI #1003558354 in Pinconning, Michigan

Provider Information

NPI Number: 1003558354
Entity Type: Individual
Name: Victoria Lauren Wise
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 8, 2022
Last Updated: Mar 1, 2023

Practice Location

Address: 4320 N 11 MILE RD
City: Pinconning
State: Michigan
ZIP Code: 48650-7976
Phone: (989) 313-3069

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X
Behavior Technician	106S00000X	Primary

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