Provider Demographics
NPI:1205387875
Name:CALER, LYNNSE LEANNE
Entity Type:Individual
Prefix:MISS
First Name:LYNNSE
Middle Name:LEANNE
Last Name:CALER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9351 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5437
Mailing Address - Country:US
Mailing Address - Phone:804-596-3275
Mailing Address - Fax:
Practice Address - Street 1:9351 W BROAD ST
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-5437
Practice Address - Country:US
Practice Address - Phone:804-596-3275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician