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Individual

AMANDA M WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2700 LAFAYETTE ST, FORT WAYNE, IN 46806-1100
(260) 481-2770
(260) 481-2771
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008266A
IN

Other

Enumeration date
07/08/2016
Last updated
04/20/2023
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