Provider Demographics
NPI:1811102973
Name:LINVILLE, LYN (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:LINVILLE
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10130 S 185TH DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4911
Mailing Address - Country:US
Mailing Address - Phone:623-386-6046
Mailing Address - Fax:
Practice Address - Street 1:10130 S 185TH DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4911
Practice Address - Country:US
Practice Address - Phone:623-386-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist