Provider Demographics
NPI:1326314600
Name:WISE AND WISE, L.L.P.
Entity Type:Organization
Organization Name:WISE AND WISE, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-262-2828
Mailing Address - Street 1:2346 PATUXENT RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1910
Mailing Address - Country:US
Mailing Address - Phone:301-262-2828
Mailing Address - Fax:
Practice Address - Street 1:14300 GALLANT FOX LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4003
Practice Address - Country:US
Practice Address - Phone:301-262-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty