Individual
MELANIE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3753
(631) 920-8300
Mailing address
11 ROUTE 111, SMITHTOWN, NY 11787-3753
(631) 920-8300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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