Individual
DR. KATHRYN P. WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-8060
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1912
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0483N
BCBS NC
NC
01
—
71451
MEDCOST
NC
Enumeration date
10/11/2006
Last updated
08/13/2021
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