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1285027003
LARRY SHANE WYATT
CROSSVILLE, TN
NPI
1285027003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: TN 3239)
Enumeration Date
2015-03-18
Last Update Date
2015-03-18
Business Address
MR. LARRY SHANE WYATT LPC
261 YVONNE AVE
CROSSVILLE, TN 38555-4735
Phone number: 931-456-2859
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Mailing Address
MR. LARRY SHANE WYATT LPC
261 YVONNE AVE
CROSSVILLE, TN 38555-4735
Phone number: 931-456-2859
Copy
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