Individual
KELLY LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A
Contact information
Practice address
43 BAXTER BLVD, PORTLAND, ME 04101-1823
(207) 775-6381
(207) 775-3378
Mailing address
43 BAXTER BLVD, PORTLAND, ME 04101-1823
(207) 775-6381
(207) 775-3378
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AP815
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110570100
—
ME
05
—
110570101
—
ME
05
—
325660099
—
ME
05
—
431565800
—
ME
Enumeration date
08/10/2006
Last updated
07/09/2007
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