Individual
BENJAMIN KEITH WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CMHC
Contact information
Practice address
921 E 86TH ST STE 210, INDIANAPOLIS, IN 46240-1841
(812) 568-3641
Mailing address
921 E 86TH ST STE 210, INDIANAPOLIS, IN 46240-1841
(812) 568-3641
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99123609A
IN
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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