Provider Demographics
NPI:1437223609
Name:NORMAN, LYNDA BETH (LIC MTH, LIC AC)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:BETH
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LIC MTH, LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-3222
Mailing Address - Country:US
Mailing Address - Phone:508-359-7012
Mailing Address - Fax:
Practice Address - Street 1:53 LANGLEY RD
Practice Address - Street 2:SUITE 340
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1913
Practice Address - Country:US
Practice Address - Phone:781-771-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist