Individual
DESTINY WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2313 W ARKANSAS LN STE 103, PANTEGO, TX 76013-6034
(469) 249-1355
Mailing address
355 LAS COLINAS BLVD E APT 317, IRVING, TX 75039-6247
(214) 574-6032
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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