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General NPI Number Information
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NPI Number | 1336815646
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Entity Type | Organization
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Legal Business Name | WYATT & WALKER LLC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2525 LAKEWARD DR STE 110
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City | JACKSON
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State | MS
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Zip | 39216-4827
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Country | US
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Telephone | 601-981-8846
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Fax | 601-981-8873
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Provider Business Mailing Address
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Address Line | 2525 LAKEWARD DR STE 110
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City | JACKSON
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State | MS
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Zip | 39216-4827
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Country | US
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Telephone | 601-981-8846
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Fax | 601-981-8873
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CATHERINE ASHY
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Credential |
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Telephone | 601-953-8420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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