Provider Demographics
NPI:1881139251
Name:KIERNAN, LYNN
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KIERNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 E ROUTE 70
Mailing Address - Street 2:BLDG A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2341
Mailing Address - Country:US
Mailing Address - Phone:856-797-4721
Mailing Address - Fax:856-797-4785
Practice Address - Street 1:765 E ROUTE 70
Practice Address - Street 2:BLDG A
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-797-4721
Practice Address - Fax:856-797-4785
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical