Individual
MR. DANIEL ELLIOT WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPE-I
Contact information
Practice address
1101 W MORGAN ST STE 8, PARAGOULD, AR 72450-3949
(870) 335-9483
(870) 933-9487
Mailing address
4852 GREGORY CV, JONESBORO, AR 72401-7943
(870) 897-0977
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
13-08EI
AR
Other
Enumeration date
07/26/2012
Last updated
10/24/2018
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