| Doctor Name: | MR. BRUCE CHARLES WYMAN |
| NPI Number: | 1821109331 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, EDM, NCC |
| License Number: | 0701003919 |
| Business Practice Address: | 10391 Greyson Ln Rixeyville, VA - 227371730 |
| Business Phone Number: | 5409374923 |
| Business Fax Number: | 5409377680 |
| Mailing Address: | Po Box 373, RIXEYVILLE |
| State: | VA |
| Postal Code: | 227370373 |
| Phone Number: | 5409374923 |
| Fax Number: | 5409377680 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0701003919 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |