Individual
MRS. REBECCA LOUISE WYDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC-S
Contact information
Practice address
1349 E STROOP RD, KETTERING, OH 45429-4925
(937) 293-1115
Mailing address
3949 ROBERTANN DR, KETTERING, OH 45420-1062
(937) 219-5439
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E 0003507
OH
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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