NPI 1871360727

Mark Stephen Wise

Practitioner Psychoanalyst Marietta, GA

Practice location

Address: 2501 E Piedmont Rd STE 202, Marietta, GA 30062-7758
Phone: (470) 435-1547

Registered specialties

Psychoanalyst Primary

Behavioral Health & Social Service Providers Taxonomy 102L00000X Licence LPC014257 (GA)

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Registry record

NPI: 1871360727
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Dec 2023
Record last updated: 11 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.