Wyatt, Shannon M

Wyatt, Shannon M is an individual health care provider with primary practice located at 245 Fountain Ct Ste 225 , Lexington KY 40509-1888. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wyatt, Shannon M can be contacted via phone (859) 323-6021.

Contact Information

Primary practice address
245 Fountain Ct Ste 225 Lexington KY 40509-1888
Phone: (859) 323-6021
Fax: (859) 257-2076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 103403 Kentucky

Profile Details

NPI number 1184770026
LBN Legal business name Wyatt, Shannon M
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jun 16th, 2018 - about 8 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 1184770026 NPPES
Kentucky MEDICAID 710028980

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