Individual
JESSICA WYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24200 CHAGRIN BLVD, BEACHWOOD, OH 44122-5550
(216) 831-6466
Mailing address
24200 CHAGRIN BLVD, BEACHWOOD, OH 44122-5550
(216) 831-6466
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1400672
OH
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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