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General NPI Number Information
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NPI Number | 1134402381
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Entity Type | Individual
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Provider Name | IRIS BONITA LYNCH CADC-11
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 18646 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1411
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Country | US
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Telephone | 818-996-1051
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Fax |
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Provider Business Mailing Address
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Address Line | 911 N NORTHWOOD AVE
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City | COMPTON
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State | CA
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Zip | 90220-1640
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Country | US
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Telephone | 818-217-7034
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | RAS71011
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License Number State | CA
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