Individual
MS. ELIZABETH MARIE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1009 N GEORGETOWN ST, ROUND ROCK, TX 78664-3289
(512) 255-1720
(512) 244-8371
Mailing address
1009 N GEORGETOWN ST, ROUND ROCK, TX 78664-3289
(512) 255-1720
(512) 244-8371
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
02/12/2007
Last updated
07/08/2007
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