Provider Demographics
NPI:1912090382
Name:LYNCH, ELIZABETH (PSY,D,)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PSY,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3905
Mailing Address - Country:US
Mailing Address - Phone:301-881-4884
Mailing Address - Fax:
Practice Address - Street 1:6339 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3905
Practice Address - Country:US
Practice Address - Phone:301-881-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02788103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical