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Individual

MS. DEBRA LYNN WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.W., L.C.S.W.

Contact information

Practice address
HC 1 BOX 776, 715 LEUCKEL DRIVE, VAN BUREN, MO 63965-9733
(573) 300-7506
Mailing address
HC 1 BOX 776, 715 LEUCKEL DRIVE, VAN BUREN, MO 63965-9733
(573) 300-7506

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001005008
MO

Other

Enumeration date
11/04/2005
Last updated
07/10/2012
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