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General NPI Number Information
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NPI Number | 1902553316
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Entity Type | Organization
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Legal Business Name | WISE COUNSELING CENTER
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Dates
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Enumeration Date | 03/05/2022
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Last Update Date | 03/05/2022
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Provider Practice Location Address
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Address Line | 4408 PEACH ST # 201
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City | ERIE
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State | PA
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Zip | 16509-1374
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Country | US
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Telephone | 814-392-5681
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Fax |
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Provider Business Mailing Address
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Address Line | 4408 PEACH ST # 201
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City | ERIE
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State | PA
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Zip | 16509-1374
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | ELIZABETH WISE
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Credential | DO
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Telephone | 814-392-5681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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