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Mr. Samuel Wylie, LPC
Professional Counselor in San Angelo, Texas
NPI 1639467830

Samuel Wylie is a Professional Counselor based in San Angelo, TX and is specialized in Professional. Samuel Wylie practices in San Angelo, TX and has the professional credentials of LPC. The NPI Number for Samuel Wylie is 1639467830 and holds a License No. 11531 (Texas).

The current practice location address for Samuel Wylie is 3136 Executive Dr, San Angelo, TX and can be reached out via phone at 325-944-3692.

Location: 3136 Executive Dr, San Angelo, TX, 76904-6802
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639467830
Provider Name
Samuel Wylie
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
3136 Executive Dr, San Angelo, TX, 76904-6802
Phone Number
325-944-3692
Fax Number
Provider Enumeration Date
07/21/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
TPI - 025674502 05 TX
institution
Provider Business Practice Location Address Details
Address
3136 Executive Dr
City
San Angelo
State
Texas
Zip
76904-6802
Phone Number
325-944-3692
Fax Number
person
Provider Business Mailing Address Details
Address
3136 Executive Dr
City
San Angelo
State
Texas
Zip
76904-6802
Phone Number
325-944-3692
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
11531 (Texas)
Definition
Definition to come...
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