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Individual

LISA C AFONSO LYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
621 DEXTER ST, CENTRAL FALLS, RI 02863-2603
(401) 721-9200
Mailing address
621 DEXTER ST, CENTRAL FALLS, RI 02863-2603
(401) 721-9200

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00418
RI
174400000X
Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2092
EI NHPRC
RI
01
292177
EI BLUE CROSS
RI
01
412296
EI BCHIP
RI
01
6400144
EI UHP
RI
05
ES01788
RI
Enumeration date
09/20/2006
Last updated
06/10/2009
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