Provider Demographics
NPI:1003228453
Name:LYNN M. WILBY LLC
Entity Type:Organization
Organization Name:LYNN M. WILBY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILBY
Authorized Official - Suffix:
Authorized Official - Credentials:MED LPC
Authorized Official - Phone:215-316-9434
Mailing Address - Street 1:1 BRITTON PL STE 6
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:215-316-9434
Mailing Address - Fax:856-864-0310
Practice Address - Street 1:1 BRITTON PL STE 6
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:215-316-9434
Practice Address - Fax:856-864-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty