Provider Demographics
NPI:1194404236
Name:LYNCH, AIMEE LYNN (RD LD)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:LYNN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:LYNN
Other - Last Name:BARTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:1220 TIMBERCREST ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1266
Mailing Address - Country:US
Mailing Address - Phone:330-799-2627
Mailing Address - Fax:
Practice Address - Street 1:726 WICK AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2827
Practice Address - Country:US
Practice Address - Phone:330-747-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered