Individual
MS. TERESA DANIELLE RIDENER WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 745, WHITLEY CITY, KY 42653-0745
(606) 310-0777
Mailing address
PO BOX 745, WHITLEY CITY, KY 42653-0745
(606) 310-0777
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
04/05/2024
Last updated
05/03/2024
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