Individual
SANDRA JEAN WYNN-STELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LLP BCBA
Contact information
Practice address
680 3 MILE RD NW, SUITE C, GRAND RAPIDS, MI 49544-8218
(616) 647-3460
(616) 647-3467
Mailing address
680 3 MILE RD NW, SUITE C, GRAND RAPIDS, MI 49544-8218
(616) 647-3460
(616) 647-3467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-14-15612
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301008405
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
6301008405
MI
Other
Enumeration date
11/01/2007
Last updated
04/17/2020
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