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Individual

KYLE WYMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 594-1445
Mailing address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 594-1445

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
CW022109
PA

Other

Enumeration date
08/20/2018
Last updated
11/18/2024
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