Individual
MATTHEW WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 BYRDHILL ROAD, RICHMOND, VA 23220
(804) 572-5514
Mailing address
5400 BYRDHILL RD, RICHMOND, VA 23228-5807
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-15-6783
VA
Other
Enumeration date
04/25/2016
Last updated
07/07/2016
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