Provider Demographics
NPI:1003924184
Name:HUNGERFORD, LYNN ELLEN (PHD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ELLEN
Last Name:HUNGERFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890382
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289
Mailing Address - Country:US
Mailing Address - Phone:281-218-7900
Mailing Address - Fax:281-218-6601
Practice Address - Street 1:1300 BAY AREA BLVD BLDG B #125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2505
Practice Address - Country:US
Practice Address - Phone:281-218-7900
Practice Address - Fax:281-218-6601
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23076103T00000X
TX6697103T00000X
TX2495103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist