Mary Lou Wise, LCSW

NPI #1427290501 in Orem, Utah

Provider Information

NPI Number: 1427290501
Entity Type: Individual
Name: Mary Lou Wise, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Apr 3, 2009
Last Updated: Apr 3, 2009

Practice Location

Address: 1790 N STATE ST
City: Orem
State: Utah
ZIP Code: 84057-2025
Phone: (801) 224-8255

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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