Individual
JEAN M. WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16 APACHE PL, RIVERSIDE, CT 06878-1328
(203) 645-3814
Mailing address
16 APACHE PL, RIVERSIDE, CT 06878-1328
(203) 645-3814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
010881
CT
1041C0700X
Clinical Social Worker
Primary
084819-1
NY
Other
Enumeration date
10/18/2016
Last updated
04/17/2023
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