| Doctor Name: | CHRISTINE ANN WISDOM |
| NPI Number: | 1003189812 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 9083 |
| Business Practice Address: | 21000 Torrence Chapel Rd Suite 200 Cornelius, NC - 280316873 |
| Business Phone Number: | 7049603619 |
| Business Fax Number: | 7048967748 |
| Mailing Address: | 21000 Torrence Chapel Rd, Suite 200 CORNELIUS |
| State: | NC |
| Postal Code: | 280316873 |
| Phone Number: | 7049603619 |
| Fax Number: | 7048967748 |
| NPI Enumeration Date: | 02/10/2012 |
| NPI Last Update Date: | 06/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 9083 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |