Individual
JAMERLIA WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
127 S BROADWAY, YONKERS, NY 10701-4006
(914) 378-7000
Mailing address
10841 FLATLANDS AVE APT 2C, BROOKLYN, NY 11236-2923
(347) 213-3479
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RV81436J
—
NY
Enumeration date
10/20/2017
Last updated
10/20/2017
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