Provider Demographics
NPI:1396331286
Name:LYNCH, DURIE LEIDNER (BCBA)
Entity type:Individual
Prefix:
First Name:DURIE
Middle Name:LEIDNER
Last Name:LYNCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HEIGHTS TER
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1322
Mailing Address - Country:US
Mailing Address - Phone:732-310-2109
Mailing Address - Fax:
Practice Address - Street 1:7 HEIGHTS TER
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1322
Practice Address - Country:US
Practice Address - Phone:732-310-2109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst