Individual
JALICIA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
7500 DOLLARWAY RD STE 105, WHITE HALL, AR 71602-3082
(870) 247-2305
(870) 247-2330
Mailing address
7500 DOLLARWAY RD STE 105, WHITE HALL, AR 71602-3082
(870) 247-2305
(870) 247-2330
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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