Provider Demographics
NPI:1194740076
Name:KINSELL, LYNN (PH D)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:KINSELL
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RATHBUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PH D
Mailing Address - Street 1:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89407-1064
Mailing Address - Country:US
Mailing Address - Phone:775-423-4267
Mailing Address - Fax:775-423-4541
Practice Address - Street 1:110 W B ST
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2913
Practice Address - Country:US
Practice Address - Phone:775-423-4267
Practice Address - Fax:775-423-4541
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV163103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPHD163BMedicare ID - Type UnspecifiedPSYCHOLOGIST