Individual
DEBRA ANN WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1257 MARYWOOD LN, RICHMOND, VA 23229-6059
(804) 741-0612
Mailing address
5721 QUIET PINE CIR, APT 101, CHESTER, VA 23831-7715
(828) 707-1026
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001369
VA
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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