Wyatt, Mary Ann

Wyatt, Mary Ann is an sole proprietor health care provider with primary practice located at 1030 Kingshighway St Ste A , Rolla MO 65401-2930. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Wyatt, Mary Ann can be contacted via phone (816) 425-2833.

Contact Information

Primary practice address
1030 Kingshighway St Ste A Rolla MO 65401-2930
Fax: (816) 425-2908
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 2012036248 Missouri

Profile Details

NPI number 1710252333
LBN Legal business name Wyatt, Mary Ann
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2012
Last updated Feb 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710252333 NPPES
Missouri MEDICAID 1710252333

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