Doctor Name: | DANIEL L. WYATT |
NPI Number: | 1629084967 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 77486 |
Business Practice Address: | 49 Harry Kemp Way Provincetown, MA - 02657 |
Business Phone Number: | 5084879395 |
Business Fax Number: | 5084873285 |
Mailing Address: | Po Box 1413, WELLFLEET |
State: | MA |
Postal Code: | 02667 |
Phone Number: | 5082400208 |
Fax Number: | 5082400499 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 77486 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |