Provider Demographics
NPI:1841468451
Name:LYNCH, TAMARA R (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:R
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:TAMARA
Other - Middle Name:R
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:100 SHA RO LEY LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42261-8249
Mailing Address - Country:US
Mailing Address - Phone:270-999-0169
Mailing Address - Fax:
Practice Address - Street 1:100 SHA RO LEY LN
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:KY
Practice Address - Zip Code:42261-8249
Practice Address - Country:US
Practice Address - Phone:270-999-0169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-16
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist