| Amanda M. Wyatt, Llc | |
|
2005 Valparaiso St Ste 107 Valparaiso IN 46383-3330 | |
| (219) 929-6205 | |
| Not Available |
| Full Name | Amanda M. Wyatt, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2005 Valparaiso St Ste 107, Valparaiso, Indiana |
| Authorized Official Name and Position | Amanda M Wyatt (OWNER) |
| Authorized Official Contact | 2199296205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda M. Wyatt, Llc 3205 Clairborne Xing Valparaiso IN 46385-2970 Ph: (219) 929-6205 | Amanda M. Wyatt, Llc 2005 Valparaiso St Ste 107 Valparaiso IN 46383-3330 Ph: (219) 929-6205 |
| NPI Number | 1912417601 |
|---|---|
| Provider Enumeration Date | 10/06/2017 |
| Last Update Date | 10/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912417601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 39001619A (Indiana) | Primary |
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