Individual
MR. LARRY SHANE WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
261 YVONNE AVE, CROSSVILLE, TN 38555-4735
(931) 456-2859
(931) 707-8921
Mailing address
261 YVONNE AVE, CROSSVILLE, TN 38555-4735
(931) 456-2859
(931) 707-8921
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3239
TN
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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