Provider Demographics
NPI:1083748917
Name:SCHWARTZ, LYNN (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11664 LOG JUMP TRL
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1500
Mailing Address - Country:US
Mailing Address - Phone:410-992-9340
Mailing Address - Fax:410-761-8668
Practice Address - Street 1:8821 COLUMBIA 100 PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2168
Practice Address - Country:US
Practice Address - Phone:410-992-9340
Practice Address - Fax:410-761-8668
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00482171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD53459101OtherBLUE CROSS BLUE SHIELD