Provider Demographics
NPI:1699950246
Name:LYNCH, CLINITA SINGLETON (MHS,OTR/L-CLT)
Entity type:Individual
Prefix:
First Name:CLINITA
Middle Name:SINGLETON
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MHS,OTR/L-CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1982 ROCKLEDGE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3723
Mailing Address - Country:US
Mailing Address - Phone:321-433-3650
Mailing Address - Fax:321-433-3652
Practice Address - Street 1:1982 ROCKLEDGE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3723
Practice Address - Country:US
Practice Address - Phone:321-433-3650
Practice Address - Fax:321-433-3652
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist