| Doctor Name: | MRS. KRISTINA GAY WYNN |
| NPI Number: | 1356436653 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW,CADC,RN |
| License Number: | 5573 |
| Business Practice Address: | 5320 159th Street Suite 100 Oak Forest, IL - 60452 |
| Business Phone Number: | 7087170191 |
| Business Fax Number: | |
| Mailing Address: | 390 E. Bethel, BOURBONNAIS |
| State: | IL |
| Postal Code: | 60914 |
| Phone Number: | 7089360778 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 5573 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |