Basic Information
| Provider Information | |||||||||
| NPI: | 1699950246 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LYNCH | ||||||||
| FirstName: | CLINITA | ||||||||
| MiddleName: | SINGLETON | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MHS,OTR/L-CLT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1982 ROCKLEDGE BLVD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ROCKLEDGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329553723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3214333650 | ||||||||
| FaxNumber: | 3214333652 | ||||||||
| Practice Location | |||||||||
| Address1: | 1982 ROCKLEDGE BLVD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ROCKLEDGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329553723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3214333650 | ||||||||
| FaxNumber: | 3214333652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2008 | ||||||||
| LastUpdateDate: | 01/02/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | OT4250 | FL | Y | Other Service Providers | Specialist |
No ID Information.