Individual
KENYA WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
418B W MOUNTAIN ST STE B, KERNERSVILLE, NC 27284-2534
(801) 614-2587
Mailing address
418 W MOUNTAIN ST STE B, KERNERSVILLE, NC 27284-2534
(801) 614-2587
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-20-42838
NC
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/21/2018
Last updated
09/01/2021
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