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General NPI Number Information
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NPI Number | 1861765455
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Entity Type | Individual
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Provider Name | SHERRY LANETTE WISE-MAYS
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Gender | Female
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 11 ASH CT NE
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City | CARTERSVILLE
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State | GA
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Zip | 30121-6027
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Country | US
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Telephone | 404-642-6947
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 213
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City | CARTERSVILLE
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State | GA
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Zip | 30120-0213
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Country | US
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Telephone | 404-642-6947
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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