Individual
ANDRIA JOY NICHELLE WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 PEACHTREE ST NW, ATLANTA, GA 30303-1202
(888) 880-9270
Mailing address
500 FAIRWAY DR, DEERFIELD BEACH, FL 33441-1814
(888) 880-9272
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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