Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1154767044 |
---|---|
Provider Name | Dr. Lynne Ann Mayo |
First Address | Hazleton, PA 18201-2839 |
Second Address | Hazleton, PA 18201-2839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 17/05/2013 |