Healthcare Provider Details

I. General information

NPI: 1437486602
Provider Name (Legal Business Name): MERRY CHARLOTTE LYNCH CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 E SUNNYSLOPE LN
PHOENIX AZ
85020-2729
US

IV. Provider business mailing address

1510 E SUNNYSLOPE LN
PHOENIX AZ
85020-2729
US

V. Phone/Fax

Practice location:
  • Phone: 602-795-1066
  • Fax: 602-476-1350
Mailing address:
  • Phone: 602-795-1066
  • Fax: 602-476-1350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number6322
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: