Organization Name: | A WISE SOLUTION, LLC. |
NPI Number: | 1942686522 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHIRLEY JOSEPH (CEO/LICENSED PROFESSIONAL COUNSELOR) |
Mailing Address: | 102 Greg St Carencro |
State: | LA US |
Postal Code: | 705206248 |
Phone Number: | 3375236770 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2015 |
NPI Last Update Date: | 08/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5529 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |