Teresa Danielle Ridener Wyatt

Individual provider Active NPI Developmental Therapist · Whitley City, KY

NPI 1245082783 · NPPES record last updated May 3, 2024

Key facts

NPI
1245082783
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
PO Box 745
Whitley City, KY 42653-0745
Phone
(606) 310-0777
NPI assigned
Apr 5, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

PO Box 745
Whitley City, KY 42653-0745

Mailing address

PO Box 745
Whitley City, KY 42653-0745
Phone (606) 310-0777

Other providers in Whitley City, KY

All providers in Whitley City, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.