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Individual

MR. JERMAINE WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
140 MICHIGAN AVE NE, #T12, WASHINGTON, DC 20017-1039
(202) 569-9539
Mailing address
140 MICHIGAN AVE NE, #T12, WASHINGTON, DC 20017-1039
(202) 569-9539

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
02/14/2009
Last updated
06/23/2011
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