Provider Information for 1568106318
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HEATHER IRENE WISEMILLER LICSW
Sex: Female
NPI: 1568106318
Last Updated: 2022-04-26
Certification Date: 2022-04-26
Certification Date: 2022-04-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568106318 | ||||||||
| Enumeration Date | 2022-04-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1901 3RD ST NE FL 1 MINNEAPOLIS, MN 55418-4317 United States Phone: 715-309-9450 | Fax: | ||||||||
| Primary Practice Address | 1901 3RD ST NE FL 1 MINNEAPOLIS, MN 55418-4317 United States Phone: 715-309-9450 | Fax: | ||||||||
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