Organization
AMANDA M. WYATT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA M WYATT LMHC (OWNER)
(219) 929-6205
Entity
Organization
Contact information
Practice address
2005 VALPARAISO ST STE 107, VALPARAISO, IN 46383-3330
(219) 929-6205
Mailing address
3205 CLAIRBORNE XING, VALPARAISO, IN 46385-2970
(219) 929-6205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001619A
IN
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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