MEDICARE: LYNN COMPTON

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	103K00000X	Behavior Analyst	2021-084	AL

General Provider Information

NPI Number	:	1902575590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN COMPTON

Provider Business Mailing Address
First Line	:	146 PARK ST
Second Line	:
City	:	GROVE HILL
State	:	AL
Zip	:	36451-3132
Country	:	US
Telephone Number	:	251-275-6416
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 S RAILROAD ST
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2993
Country	:	US
Telephone Number	:	334-664-0466
Fax Number	:	334-664-0463

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

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “ LYNN COMPTON ” Practice Location

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