| NPI | 1740961176 |
|---|---|
| Former Name | MYA WYATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34009289A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 113156) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2024-09-15 |