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General NPI Number Information
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NPI Number | 1417408923
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Entity Type | Individual
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Provider Name | ERICA LYNCH
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Gender | Female
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 791 WYLIE ST SE UNIT 710
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City | ATLANTA
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State | GA
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Zip | 30316-7200
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Country | US
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Telephone | 231-690-2745
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Fax |
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Provider Business Mailing Address
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Address Line | 791 WYLIE ST SE UNIT 710
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City | ATLANTA
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State | GA
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Zip | 30316-7200
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT005404
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201007837
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License Number State | MI
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