MEDICARE: KRISTIE WYLER THERAPY PLLC

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
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1962338699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTIE WYLER THERAPY PLLC

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	:
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	:	734-564-2843
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTIE WYLER
Credential	:	LLP
Telephone Number	:	734-748-5886

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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