Individual
MIRANDA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 LINWOOD DR, PARAGOULD, AR 72450-7384
(870) 450-0585
Mailing address
2911 LINWOOD DR, PARAGOULD, AR 72450-7384
(870) 450-0585
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
48183
AR
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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