Individual
LARRY WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4037 DARLING CT SW STE B, LILBURN, GA 30047-2365
(770) 995-9789
(770) 995-9787
Mailing address
1495 WATERCOVE LN, LAWRENCEVILLE, GA 30043-7041
(770) 995-9789
(770) 995-9787
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008237
GA
Other
Enumeration date
06/26/2018
Last updated
11/28/2018
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