Individual
LYNN BOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 776-6577
Mailing address
8 S ELM ST, CANISTEO, NY 14823-1312
(607) 698-2165
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17515
NY
Other
Enumeration date
09/23/2006
Last updated
07/08/2007
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