Provider Demographics
NPI:1912211673
Name:CARR, LYNN MARIE (MED)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:CARR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5240 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-5003
Mailing Address - Country:US
Mailing Address - Phone:916-338-1001
Mailing Address - Fax:916-338-1044
Practice Address - Street 1:5240 JACKSON ST
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5003
Practice Address - Country:US
Practice Address - Phone:916-338-1001
Practice Address - Fax:916-338-1044
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst