Wise, Kathleen Marie
Wise, Kathleen Marie is an sole proprietor health care provider with primary practice located at 7600 Bass Lake Rd Suite 106, New Hope MN 55428-3860. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Wise, Kathleen Marie can be contacted via phone (612) 865-9143.Contact Information
Primary practice address
7600 Bass Lake Rd Suite 106
New Hope MN 55428-3860
Phone: (612) 865-9143
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP3227 | Minnesota |
Profile Details
| NPI number | 1871581017 |
|---|---|
| LBN Legal business name | Wise, Kathleen Marie |
| Credentials | M.A., L.P. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Jul 16th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871581017 | NPPES |
| Minnesota | MEDICAID | 500526400 |
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