Individual
MICHAEL WYVRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 WOOD ST, SISTERSVILLE, WV 26175-1523
(304) 652-1032
Mailing address
11283 RIDDLE DR, SPRING HILL, FL 34609-3441
(724) 880-0818
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2379
WV
235Z00000X
Speech-Language Pathologist
SZ6876
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013444700
—
FL
Enumeration date
09/15/2014
Last updated
03/03/2023
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