Provider Demographics
NPI:1912382599
Name:LYNN ZOLL PSYCHOLOGIST
Entity Type:Organization
Organization Name:LYNN ZOLL PSYCHOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:757-636-1229
Mailing Address - Street 1:303 34TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2855
Mailing Address - Country:US
Mailing Address - Phone:757-636-1229
Mailing Address - Fax:888-974-2116
Practice Address - Street 1:303 34TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2855
Practice Address - Country:US
Practice Address - Phone:757-636-1229
Practice Address - Fax:888-974-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001574103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty