Provider Demographics
NPI:1922151976
Name:LYNCH, EILEEN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MARES POND DR
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-5038
Mailing Address - Country:US
Mailing Address - Phone:508-540-8358
Mailing Address - Fax:
Practice Address - Street 1:10 MARES POND DR
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-5038
Practice Address - Country:US
Practice Address - Phone:508-540-8358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4903103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist