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1245365527
ANASTASIA STACY WYATT
MUNFORDVILLE, KY
NPI
1245365527
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 0762)
Enumeration Date
2007-02-23
Last Update Date
2007-07-08
Business Address
-- ANASTASIA STACY WYATT CADC
118 WEST UNION STREET
MUNFORDVILLE, KY 42765
Phone number: 270-524-9883
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Mailing Address
-- ANASTASIA STACY WYATT CADC
1686 MOREHEAD RD
BOWLING GREEN, KY 42101-6304
Phone number:
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