Individual
WYATT FLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
821 N 10TH ST, FORT SMITH, AR 72901-1505
(615) 347-3115
Mailing address
817 N 10TH ST, FORT SMITH, AR 72901-1505
(501) 766-1247
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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