Individual
MRS. ALICE FERN WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
70 N MAIN ST, SUITE 103, BOUNTIFUL, UT 84010-6101
(801) 298-5222
(801) 294-0295
Mailing address
1033 S MILLBROOK WAY, BOUNTIFUL, UT 84010-2056
(801) 243-0539
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6497798-6004
UT
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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