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Debra Wise

NPI 1275000630 · on the registry since 2018 · sole proprietor

Practice

Address
6420 Mount Ave
Saint Louis, MO 63121
Phone
(314) 458-9602
Fax
(314) 282-0158
Organisation at this address
Wings Of An Angel
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
251E00000X
251E00000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-10-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri