Provider Demographics
NPI:1548577612
Name:LYNN, QUINTEN (PHD)
Entity Type:Individual
Prefix:
First Name:QUINTEN
Middle Name:
Last Name:LYNN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 RANSER RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2656
Mailing Address - Country:US
Mailing Address - Phone:785-477-2946
Mailing Address - Fax:
Practice Address - Street 1:400 OSAGE ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5930
Practice Address - Country:US
Practice Address - Phone:785-477-2946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1892103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical