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Individual

CAROLYN WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA, COBA

Contact information

Practice address
1706 E BROAD ST, COLUMBUS, OH 43203
(614) 252-4800
Mailing address
3070 RIVERSIDE DR STE 113, COLUMBUS, OH 43221-2547

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-15-19634
103K00000X
Behavior Analyst
Primary
236
OH

Other

Enumeration date
02/09/2017
Last updated
09/06/2018
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