Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lathan Dean Wise

Individual provider Behavior Technician · NPI 1578150736

Lathan Dean Wise is a Behavior Technician in Salem, Missouri. Licensed in Missouri. Registered with an NPI since 2020.

Licensed in
MO
In the registry since
2020
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Practice location Address checks out

3400 State St Site G750
Salem, MO 65560
Phone: (000) 000-0000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence C056195007 (MO)

Record details

NPI number1578150736
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 22, 2020
Last updated in NPPESDecember 22, 2020
Certification dateDecember 17, 2020
Mailing address21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807