Provider Demographics
NPI:1114497187
Name:LYNCH, REBECCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:LYNCH
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 1:66 CYPRESS MEADOW LOOP
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-5214
Mailing Address - Country:US
Mailing Address - Phone:585-455-8542
Mailing Address - Fax:
Practice Address - Street 1:4641 FAIRFIELD ST STE F
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2763
Practice Address - Country:US
Practice Address - Phone:504-988-7250
Practice Address - Fax:504-988-7251
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program