Individual
MS. GWENDOLYNN WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
540 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-2515
(662) 544-6156
Mailing address
540 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-2515
(662) 544-6156
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3384
MS
Other
Enumeration date
08/04/2009
Last updated
08/04/2009
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