| NPI | 1720555840 |
|---|---|
| Former Name | JEANNETTE WYATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA lw61503389) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60499386) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2024-06-25 |