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Individual

MRS. JUDY M WYLIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
16917 MANCHESTER RD, GROVER, MO 63040-1209
(314) 517-5410
(636) 458-0911
Mailing address
1426 EAGLE RIDGE RD, WILDWOOD, MO 63038-2418
(636) 394-6119
(636) 458-0911

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002288
MO

Other

Enumeration date
09/22/2006
Last updated
07/08/2007
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