Provider Demographics
NPI:1730319955
Name:HESS, LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RYZEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:107 TABER AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4129
Mailing Address - Country:US
Mailing Address - Phone:917-453-3368
Mailing Address - Fax:
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-453-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01150103T00000X
NY018308-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical