Individual
DEMETRIC U WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5700 PHOENIX PL, FORT SMITH, AR 72903-5782
(479) 441-2600
(479) 441-2693
Mailing address
4253 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4593
(479) 521-5731
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6294-C
AR
Other
Enumeration date
07/14/2006
Last updated
04/16/2025
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