Individual
YOLANDA MARIE WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3151 AIRWAY AVE, COSTA MESA, CA 92626-4607
(949) 694-7172
Mailing address
3151 AIRWAY AVE, COSTA MESA, CA 92626-4607
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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