Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Berevon Tayshawn Wyatt

Individual provider Massage Therapist · NPI 1114526068

Berevon Tayshawn Wyatt is a Massage Therapist in Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2020

Practice location Address checks out

3510 N Oakland Ave Ste 206
Milwaukee, WI 53211-2746
Phone: (414) 915-4213
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 14485-146 (WI)

Record details

NPI number1114526068
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 21, 2020
Last updated in NPPESOctober 21, 2020
Certification dateOctober 21, 2020

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