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Individual

MRS. BLAIR L WYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12569 S 2700 W, RIVERTON, UT 84065-7182
(801) 209-9797
Mailing address
12569 S 2700 W, RIVERTON, UT 84065-7182
(801) 209-9797

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12837621-3502
UT

Other

Enumeration date
12/14/2020
Last updated
05/02/2024
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