Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 103K00000X | Behavior Analyst | 1-19-37672 | MN |
NPI | 1003459835 |
---|---|
Provider Name | Sarah Joy Lynch |
First Address | Coon Rapids, MN 55433-5845 |
Second Address | Coon Rapids, MN 55433-5845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2019 |
Last Update Date | 20/07/2020 |