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1285038018
GRANT J. WYLIE
LONGVIEW, WA
NPI
1285038018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-10-22
Last Update Date
2014-10-22
Business Address
-- GRANT J. WYLIE
1105 BROADWAY ST
LONGVIEW, WA 98632-3830
Phone number: 360-425-8679
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Mailing Address
-- GRANT J. WYLIE
1105 BROADWAY ST
LONGVIEW, WA 98632-3830
Phone number: 360-425-8679
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