Mark Wyly
NPI #1093065617 in Diamond Springs, California
Provider Information
- NPI Number
- 1093065617
- Entity Type
- Individual
- Name
- Mark Wyly
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Sep 11, 2012
- Last Updated
- Sep 11, 2012
Practice Location
- Address
- 768 PLEASANT VALLEY RD
- Address 2
- STE. 304
- City
- Diamond Springs
- State
- California
- ZIP Code
- 95619-9260
- Phone
- (530) 621-9800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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