Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 35SI00558200 | NJ |
Y | 103TC0700X | Clinical Psychologist | 35SI00558200 | NJ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 35SI00558200 | NJ |
NPI | 1104272517 |
---|---|
Provider Name | Sarah Lynn |
First Address | Livingston, NJ 07039 |
Second Address | Livingston, NJ 07039-3789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2016 |
Last Update Date | 05/05/2016 |