Individual
MS. SHANNON M WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
245 FOUNTAIN CT STE 225, LEXINGTON, KY 40509-1888
(859) 323-6021
(859) 257-2076
Mailing address
245 FOUNTAIN CT STE 225, LEXINGTON, KY 40509-1888
(859) 323-6021
(859) 257-2076
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
103403
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710028980
—
KY
Enumeration date
01/25/2007
Last updated
06/16/2018
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