Provider Demographics
NPI:1447783030
Name:ARNELL, LYNDA (CMLDT, LMT)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:ARNELL
Suffix:
Gender:F
Credentials:CMLDT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1441
Mailing Address - Country:US
Mailing Address - Phone:201-921-4626
Mailing Address - Fax:
Practice Address - Street 1:220 BEECH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1441
Practice Address - Country:US
Practice Address - Phone:201-921-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00977500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist