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General NPI Number Information
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NPI Number | 1225485568
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Entity Type | Organization
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Legal Business Name | EMPOWERING BALANCE, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 6010 HIGHWAY 9 STE 1
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City | FELTON
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State | CA
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Zip | 95018-9535
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Country | US
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Telephone | 972-876-9131
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 HIGHWAY 9 STE 1
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City | FELTON
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State | CA
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Zip | 95018-9535
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Country | US
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Telephone | 972-876-9131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PSYCHOLOGIST
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Name | DR. LYNELLE MARIE LYNN
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Credential | PSY.D.
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Telephone | 831-704-7257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 36032
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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