Individual
ANTONIO LAMAR WYCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4047 AILANTHUS CT, TALLAHASSEE, FL 32305-5003
(386) 466-2733
Mailing address
4047 AILANTHUS CT, TALLAHASSEE, FL 32305-5003
(386) 466-2733
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW14171
FL
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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