Individual
KATHERINE ELAINE WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT 3186
Contact information
Practice address
242 W SHAMROCK AVE UNIT 1, PINEVILLE, LA 71360-6439
(318) 484-6375
(318) 484-6232
Mailing address
242 W SHAMROCK AVE UNIT 1, PINEVILLE, LA 71360-6439
(318) 484-6375
(318) 484-6232
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT 3186
LA
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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