Individual
NICHOLAS WYTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
304 MAIN ST STE A, FARMINGTON, CT 06032-2985
(860) 674-1824
Mailing address
627 BRIGHTON PARK WAY UNIT 3109, BLOOMFIELD, CT 06002-3172
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6453
CT
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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