Provider Demographics
NPI:1184839821
Name:CALL, WYNN W
Entity Type:Individual
Prefix:DR
First Name:WYNN
Middle Name:W
Last Name:CALL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:WYNN
Other - Middle Name:W
Other - Last Name:CALL, PH.D
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1150 N COUNTRY CLUB DR
Mailing Address - Street 2:SUITE # 10
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2537
Mailing Address - Country:US
Mailing Address - Phone:480-836-8883
Mailing Address - Fax:480-962-4308
Practice Address - Street 1:1150 N COUNTRY CLUB DR
Practice Address - Street 2:SUITE # 10
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2537
Practice Address - Country:US
Practice Address - Phone:480-836-8883
Practice Address - Fax:480-962-4308
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 1434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health