Provider Demographics
NPI:1366681116
Name:LYNN, CENDRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CENDRA
Middle Name:
Last Name:LYNN
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 1:121 CREST ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4251
Mailing Address - Country:US
Mailing Address - Phone:734-761-1960
Mailing Address - Fax:
Practice Address - Street 1:121 CREST ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4251
Practice Address - Country:US
Practice Address - Phone:734-761-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006063174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist