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General NPI Number Information
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NPI Number | 1992067052
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Entity Type | Organization
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Legal Business Name | LYNNE B. HAZARD, PH.D. & ASSOCIATES, INC.
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 6201 EXECUTIVE BLVD
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City | ROCKVILLE
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State | MD
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Zip | 20852-3906
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Country | US
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Telephone | 301-770-2847
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 EXECUTIVE BLVD
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City | ROCKVILLE
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State | MD
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Zip | 20852-3906
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Country | US
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Telephone | 301-770-2847
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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. LYNNE B. HAZARD
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Credential | PH.D.
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Telephone | 301-770-2847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 02129
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1580
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License Number State | VA
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