Individual
JULIE ANNA WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA MS
Contact information
Practice address
2924 KNIGHT ST, SHREVEPORT, LA 71105-2415
(318) 631-1122
Mailing address
5704 PAMPUS LN, BOSSIER CITY, LA 71112-4953
(318) 469-9681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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