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General NPI Number Information
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NPI Number | 1750951422
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Entity Type | Organization
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Legal Business Name | TERESA JEAN LYNCH
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 1717 E SUGNET RD
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City | MIDLAND
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State | MI
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Zip | 48642-3827
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Country | US
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Telephone | 989-615-5989
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Fax | 989-607-2119
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Provider Business Mailing Address
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Address Line | 3909 LANCASTER ST
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City | MIDLAND
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State | MI
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Zip | 48642-3758
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Country | US
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Telephone | 989-615-5989
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Fax | 989-607-2119
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERESA J LYNCH
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Credential | PHD
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Telephone | 989-615-5989
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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 |
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License Number State |
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