Healthcare Provider Details

I. General information

NPI: 1669180212
Provider Name (Legal Business Name): CLAIRE NEWMAN WYLY MS, PLPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7336 HIGHLAND RD
BATON ROUGE LA
70808-6609
US

IV. Provider business mailing address

7336 HIGHLAND RD
BATON ROUGE LA
70808-6609
US

V. Phone/Fax

Practice location:
  • Phone: 225-277-6454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: