Individual
AUSTIN BLAIN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
118 E CHOCCOLOCCO ST, OXFORD, AL 36203-1222
(256) 831-4601
Mailing address
7915 COUNTY ROAD 20, LEESBURG, AL 35983-5126
(256) 706-2091
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6271B
AL
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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