Provider Demographics
NPI:1891278263
Name:LYNCH, THERESE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8476 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1872
Mailing Address - Country:US
Mailing Address - Phone:216-870-8601
Mailing Address - Fax:
Practice Address - Street 1:13070 DURKEE RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-1122
Practice Address - Country:US
Practice Address - Phone:440-748-6869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7741235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist