Individual
SAMANTHA WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
3220 TRIMBLESTONE LN, APT 302, RALEIGH, NC 27616-5931
(248) 990-6153
Mailing address
3220 TRIMBLESTONE LN, APT 302, RALEIGH, NC 27616-5931
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
12010A
NC
Other
Enumeration date
11/30/2016
Last updated
12/05/2016
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