Individual
MARY WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10899 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-3926
(505) 460-7103
Mailing address
10899 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-3926
(505) 460-7103
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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