Provider Demographics
NPI:1154767044
Name:MAYO, LYNNE ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:ANN
Last Name:MAYO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-2839
Mailing Address - Country:US
Mailing Address - Phone:570-401-3780
Mailing Address - Fax:
Practice Address - Street 1:764 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-2839
Practice Address - Country:US
Practice Address - Phone:570-401-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral