Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1104582253 |
---|---|
Provider Name | Kathleen Lynch |
First Address | Brockton, MA 02301-7122 |
Second Address | Brockton, MA 02301-7122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2021 |
Last Update Date | 12/11/2021 |