Provider Demographics
NPI:1043853963
Name:AUBIN, LYNN (MT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:AUBIN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 LEISURE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2889
Mailing Address - Country:US
Mailing Address - Phone:518-265-7809
Mailing Address - Fax:508-477-1458
Practice Address - Street 1:148 LEISURE GREEN DR
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2889
Practice Address - Country:US
Practice Address - Phone:518-265-7809
Practice Address - Fax:508-477-1458
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005524225700000X
MA15821225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty