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General NPI Number Information
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NPI Number | 1851220271
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Entity Type | Individual
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Provider Name | KATHY J WISE MA
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Gender | Female
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 921 MINERAL RD
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City | GLENVILLE
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State | WV
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Zip | 26351-1342
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Country | US
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Telephone | 304-974-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 139 RIVER ST 139 RIVER STREET
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City | GLENVILLE
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State | WV
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Zip | 26351-9515
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Country | US
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Telephone | 304-974-5000
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Fax | 304-765-2634
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | WV
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