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Organization

T. WYATT LLC

Active
Other names
Tracey K. Wyatt, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TRACEY K WYATT LPC (LICENSED PROFESSIONAL COUNSELOR/CEO)
(800) 340-8020
Entity
Organization

Contact information

Practice address
834 PRINCE AVE, ATHENS, GA 30606-2724
(800) 340-8020
Mailing address
834 PRINCE AVE, ATHENS, GA 30606-2724
(800) 340-8020

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
006178
GA

Other

Enumeration date
12/12/2013
Last updated
12/12/2013
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