Provider Demographics
NPI:1104476886
Name:HAMER, LYNNE MARIE
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:HAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 W 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PARKESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19365-1204
Mailing Address - Country:US
Mailing Address - Phone:610-280-7577
Mailing Address - Fax:
Practice Address - Street 1:436 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:PARKESBURG
Practice Address - State:PA
Practice Address - Zip Code:19365-1204
Practice Address - Country:US
Practice Address - Phone:610-280-7577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health