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NPI Code Detail

MEDICARE: ROBERT DANIEL LYNN

MEDICARE: ROBERT DANIEL LYNN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2023032435MO
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1063139251
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DANIEL LYNN
Provider Business Mailing Address
First Line : 94 HOLLISTER CT
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-7837
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 94 HOLLISTER CT
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-7837
Country : US
Telephone Number : 314-305-0041
Fax Number : 314-338-4159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2022
Last Update Date : 12/05/2025

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