| Doctor Name: | JODY LYNNE WISEMAN |
| NPI Number: | 1033425061 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | 007620 |
| Business Practice Address: | 124 N. Federal Avenue Mason City, IA - 50401 |
| Business Phone Number: | 6414233864 |
| Business Fax Number: | 6414233836 |
| Mailing Address: | 124 N. Federal Avenue, MASON CITY |
| State: | IA |
| Postal Code: | 50401 |
| Phone Number: | 6414233864 |
| Fax Number: | 6414233836 |
| NPI Enumeration Date: | 08/27/2010 |
| NPI Last Update Date: | 09/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 007620 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |