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Individual

EGAN WYNNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10131 COORS BLVD NW STE I1, ALBUQUERQUE, NM 87114-4048
(505) 336-0560
Mailing address
2805 S INDUSTRIAL HWY STE 100, ANN ARBOR, MI 48104-6791

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-26-170033
NM
106S00000X
Behavior Technician

Other

Enumeration date
01/11/2022
Last updated
06/15/2026
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