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Individual

CHARLETA CHAVETTE WYLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1190 W ROOSEVELT BLVD, MONROE, NC 28110-2818
(704) 296-6200
(704) 296-4668
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10294
SC
1041C0700X
Clinical Social Worker
Primary
C008352
NC
1041C0700X
Clinical Social Worker
CSW004812
GA

Other

Enumeration date
12/02/2008
Last updated
05/17/2017
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