Healthcare Provider Details

I. General information

NPI: 1245126747
Provider Name (Legal Business Name): DEMARISH N. WYLLIE DNW EDUCATION & TRAINING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4603 JAYMAR DR
SUGAR LAND TX
77479-5228
US

IV. Provider business mailing address

4603 JAYMAR DR
SUGAR LAND TX
77479-5228
US

V. Phone/Fax

Practice location:
  • Phone: 832-441-5124
  • Fax:
Mailing address:
  • Phone: 281-932-2833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEMARISH WYLLIE
Title or Position: OWNER
Credential: LCDC, SAP, CART
Phone: 281-932-2833