Provider Demographics
NPI:1699481093
Name:SANTANA-WYNN, JARI (PHD)
Entity type:Individual
Prefix:DR
First Name:JARI
Middle Name:
Last Name:SANTANA-WYNN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MAHOPAC DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-3819
Mailing Address - Country:US
Mailing Address - Phone:302-468-6722
Mailing Address - Fax:
Practice Address - Street 1:41 MAHOPAC DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-3819
Practice Address - Country:US
Practice Address - Phone:302-468-6722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health