Individual
LYNNE DORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 PANAMA ST, PHILADELPHIA, PA 19103-6474
(215) 859-1773
Mailing address
2501 PANAMA ST, PHILADELPHIA, PA 19103-6474
(215) 859-1773
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005015-L
PA
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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