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Kelly Diane Wylie
Addiction (Substance Use Disorder) Counselor in Bandera, Texas
NPI 1801673769

Kelly Diane Wylie is an Addiction (Substance Use Disorder) Counselor based in Medina, TX and is specialized in Addiction (Substance Use Disorder). Kelly Diane Wylie practices in Bandera, TX. The NPI Number for Kelly Diane Wylie is 1801673769 and holds a License No. 64298 (Texas).

The current practice location address for Kelly Diane Wylie is 756 Purple Sage Rd, Bandera, TX and can be reached out via phone at 830-225-1622.

Location: 756 Purple Sage Rd, Bandera, TX, 78055-3819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801673769
Provider Name
Kelly Diane Wylie
Credential
Provider Entity Type
Individual
Gender
Female
Address
756 Purple Sage Rd, Bandera, TX, 78055-3819
Phone Number
830-225-1622
Fax Number
Provider Enumeration Date
09/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
756 Purple Sage Rd
City
Bandera
State
Texas
Zip
78003-3981
Phone Number
830-225-1622
Fax Number
person
Provider Business Mailing Address Details
Address
756 Purple Sage Rd
City
Bandera
State
Texas
Zip
78003-3981
Phone Number
830-225-1622
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
64298 (Texas)
Definition
Definition to come...
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