Provider Demographics
NPI:1407509342
Name:FLYNN, TOI (LLPC, MSP, TRS)
Entity Type:Individual
Prefix:
First Name:TOI
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LLPC, MSP, TRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24820 WOODCROFT DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1755
Mailing Address - Country:US
Mailing Address - Phone:313-461-6286
Mailing Address - Fax:
Practice Address - Street 1:24820 WOODCROFT DR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1755
Practice Address - Country:US
Practice Address - Phone:313-241-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health