Provider Demographics
NPI:1972142537
Name:LYNCH, COLTIN AUBRY (RBT)
Entity Type:Individual
Prefix:
First Name:COLTIN
Middle Name:AUBRY
Last Name:LYNCH
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 BELL ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6618
Mailing Address - Country:US
Mailing Address - Phone:806-367-9358
Mailing Address - Fax:
Practice Address - Street 1:6031 BELL ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6618
Practice Address - Country:US
Practice Address - Phone:806-367-9358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1866270106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician