Individual
JENNIFER WYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 HOLLEN CIR, FAIRMONT, WV 26554-5021
(304) 657-5987
Mailing address
4 HOLLEN CIR, FAIRMONT, WV 26554-5021
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/02/2024
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