Provider Demographics
NPI:1467771337
Name:GILMAN, LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:GILMAN
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 1:201 N ROSE AVE
Mailing Address - Street 2:SUITE 0001
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47405-1005
Mailing Address - Country:US
Mailing Address - Phone:812-856-8348
Mailing Address - Fax:812-856-8317
Practice Address - Street 1:201 N ROSE AVE
Practice Address - Street 2:SUITE 0001
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47405-1005
Practice Address - Country:US
Practice Address - Phone:812-856-8348
Practice Address - Fax:812-856-8317
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling