Healthcare Provider Details

I. General information

NPI: 1184637225
Provider Name (Legal Business Name): LYNN ANN LUNA JONES PH.D., ABPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5486
US

IV. Provider business mailing address

9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5486
US

V. Phone/Fax

Practice location:
  • Phone: 440-708-0188
  • Fax: 330-708-0368
Mailing address:
  • Phone: 440-708-0188
  • Fax: 330-708-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6182
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: