Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103K00000X | Behavior Analyst | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TF0000X | Family Psychologist |
NPI | 1316591498 |
---|---|
Provider Name | Nelzarie I Wynn |
First Address | Greenville, SC 29611-3850 |
Second Address | Greenville, SC 29611-3850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2019 |
Last Update Date | 19/08/2019 |