Provider Demographics
NPI:1518294610
Name:SPAVIN, LYNETTE (MSW)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:SPAVIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6451 BORASCO DR
Mailing Address - Street 2:APT. 2601
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6141
Mailing Address - Country:US
Mailing Address - Phone:321-784-1129
Mailing Address - Fax:
Practice Address - Street 1:6451 BORASCO DR
Practice Address - Street 2:APT. 2601
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6141
Practice Address - Country:US
Practice Address - Phone:321-784-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical