Provider Demographics
NPI:1891715660
Name:NAVARRE, LYNN (PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:NAVARRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9839 SNOW BIRD LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5609
Mailing Address - Country:US
Mailing Address - Phone:301-362-1710
Mailing Address - Fax:
Practice Address - Street 1:11085 LITTLE PATUXENT PKWY STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2914
Practice Address - Country:US
Practice Address - Phone:410-760-8840
Practice Address - Fax:410-760-8847
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist