Individual
MS. DIANE MARIE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1044 WESTERN AVE, ALBANY, NY 12203
(518) 475-6833
Mailing address
1044 WESTERN AVE, ALBANY, NY 12203
(518) 475-6833
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
095271
NY
Other
Enumeration date
06/02/2017
Last updated
07/21/2022
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