Healthcare Provider Details

I. General information

NPI: 1588915839
Provider Name (Legal Business Name): JOHN GRAHAM LYNCH PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 TREASURE HILLS BLVD C/O MENTAL HEALTH
HARLINGEN TX
78550-8736
US

IV. Provider business mailing address

77 SANTA ISABEL BLVD UNIT E-4
LAGUNA VISTA TX
78578-2607
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax:
Mailing address:
  • Phone: 603-357-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: