Provider Demographics
NPI:1902575590
Name:COMPTON, LYNN
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 PARK ST
Mailing Address - Street 2:
Mailing Address - City:GROVE HILL
Mailing Address - State:AL
Mailing Address - Zip Code:36451-3132
Mailing Address - Country:US
Mailing Address - Phone:251-275-6416
Mailing Address - Fax:
Practice Address - Street 1:3700 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-2993
Practice Address - Country:US
Practice Address - Phone:334-664-0466
Practice Address - Fax:334-664-0463
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2021-084103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst