Individual
MARY WYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5532 KNOX AVE S, MINNEAPOLIS, MN 55419-1504
(320) 249-5445
Mailing address
PO BOX 19163, MINNEAPOLIS, MN 55419-0163
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20290
MN
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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