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NPI Code Detail

MEDICARE: KRISTIE WYLER MA, LLP

MEDICARE:   KRISTIE  WYLER  MA, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6361007728MI

General Provider Information

NPI Number : 1730854175
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIE WYLER MA, LLP
Provider Business Mailing Address
First Line : 3300 WASHTENAW AVE STE 282
Second Line :
City : ANN ARBOR
State : MI
Zip : 48104-5184
Country : US
Telephone Number : 734-564-2843
Fax Number :
Provider Business Practice Location Address
First Line : 3300 WASHTENAW AVE STE 282
Second Line :
City : ANN ARBOR
State : MI
Zip : 48104-5184
Country : US
Telephone Number : 734-416-9098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 06/21/2026

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Directions to “ KRISTIE WYLER MA, LLP” Practice Location

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