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General NPI Number Information
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NPI Number | 1033162227
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Entity Type | Individual
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Provider Name | DAVID L. LYNN PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 2656 W MONTROSE AVE SUITE 101
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City | CHICAGO
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State | IL
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Zip | 60618-1559
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Country | US
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Telephone | 773-717-0158
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Fax | 773-409-7157
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Provider Business Mailing Address
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Address Line | 36123 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1216
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Country | US
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Telephone | 734-793-6140
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Fax | 865-560-8948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.008180
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License Number State | IL
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