Provider Demographics
NPI:1427848910
Name:KRISTEN WYNNS, PH.D., PLLC DBA WYNNS FAMILY PSYCHOLOGY
Entity type:Organization
Organization Name:KRISTEN WYNNS, PH.D., PLLC DBA WYNNS FAMILY PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-805-0182
Mailing Address - Street 1:130 PRESTON EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8433
Mailing Address - Country:US
Mailing Address - Phone:919-467-7777
Mailing Address - Fax:
Practice Address - Street 1:130 PRESTON EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8433
Practice Address - Country:US
Practice Address - Phone:919-467-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty