Grant J. Wylie
NPI #1285038018 in Longview, Washington
Provider Information
- NPI Number
- 1285038018
- Entity Type
- Individual
- Name
- Grant J. Wylie
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Oct 22, 2014
- Last Updated
- Oct 22, 2014
Practice Location
- Address
- 1105 BROADWAY ST
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-3830
- Phone
- (360) 425-8679
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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