Provider Demographics
NPI:1124393301
Name:LYNN, PATRICIA L (MA MFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:LYNN
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 OLINDA RD
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-7117
Mailing Address - Country:US
Mailing Address - Phone:808-268-3481
Mailing Address - Fax:
Practice Address - Street 1:1390 OLINDA RD
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-7117
Practice Address - Country:US
Practice Address - Phone:808-268-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist