Individual
KATHERINE M WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1096 OWLS CREEK LN, VIRGINIA BEACH, VA 23451-5842
(757) 971-2240
Mailing address
1096 OWLS CREEK LN, VIRGINIA BEACH, VA 23451-5842
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10025
VA
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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