Individual
ELLEN LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3251 ROUTE 112 STE 2, MEDFORD, NY 11763-1446
(631) 451-6007
(631) 297-8121
Mailing address
3251 ROUTE 112 STE 2, MEDFORD, NY 11763-1446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23512
NY
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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