Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MFC 44816 | CA |
NPI | 1003082686 |
---|---|
Provider Name | Thomas Lynch |
First Address | San Diego, CA 92123 |
Second Address | Vista, CA 92085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 05/05/2008 |