Provider Demographics
NPI:1003336439
Name:WISE, LAURA KATHERINE (OTR/L)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHERINE
Last Name:WISE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 E CHESTNUT ST STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2371
Mailing Address - Country:US
Mailing Address - Phone:828-475-8822
Mailing Address - Fax:828-372-4638
Practice Address - Street 1:10 REGENT PARK BLVD UNIT 10
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-3704
Practice Address - Country:US
Practice Address - Phone:828-475-8822
Practice Address - Fax:828-372-4638
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14766225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist