MEDICARE: LE'HANDRA LYNCH

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
1	1041C0700X	Clinical Social Worker	26612	MN

General Provider Information

NPI Number	:	1285399360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LE'HANDRA LYNCH

Provider Business Mailing Address
First Line	:	7848 NIAGARA LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2122
Country	:	US
Telephone Number	:	763-607-9285
Fax Number	:

Provider Business Practice Location Address
First Line	:	3764 95TH AVE NE
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-3849
Country	:	US
Telephone Number	:	651-415-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2021
Last Update Date	:	03/05/2022

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Directions to “ LE'HANDRA LYNCH ” Practice Location

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