Individual
JEFFREY THOMAS WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2204 KENTUCKY AVE, PADUCAH, KY 42003-3242
(270) 777-4490
(866) 441-1083
Mailing address
121 BYRON DR, PADUCAH, KY 42003-0963
(270) 556-8715
(866) 441-1083
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
922
KY
Other
Enumeration date
07/20/2020
Last updated
03/24/2026
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