Individual
MS. SHANNON LEIGH WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
110 CARLTON ST, ATHENS, GA 30602-5004
(770) 827-2410
Mailing address
110 PINYON PINE CIR APT 1101, ATHENS, GA 30606-5690
(770) 827-2410
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30139
GA
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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