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General NPI Number Information
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NPI Number | 1174554380
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Entity Type | Individual
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Provider Name | LYNN RAE HERR PHD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 2712 HURSTVIEW DR
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City | HURST
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State | TX
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Zip | 76054-2402
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Country | US
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Telephone | 888-365-6271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 121329
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City | ARLINGTON
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State | TX
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Zip | 76012-1329
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Country | US
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Telephone | 817-657-6876
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Fax | 832-448-2801
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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 | 23380
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License Number State | TX
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