Organization
WYLIE & ASSOCIATES BEHAVIORAL HEALTH LLC
Active
Organization
WYLIE & ASSOCIATES BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE ANN WYLIE RN MSN CNS APN (APN MANAGER)
(618) 593-0134
Entity
Organization
Contact information
Practice address
118 S SEMINARY ST, COLLINSVILLE, IL 62234-2634
(618) 855-8815
Mailing address
118 SEMINARY STREET, COLLINSVILLE, IL 62234
(618) 855-8815
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
209005228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083735443
INDIVIDUAL NPI MELANIE WYLIE
IL
Enumeration date
11/14/2016
Last updated
11/14/2016
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