Provider Demographics
NPI:1962886713
Name:LYNN LORIS OWENS, PSYD, LLC
Entity type:Organization
Organization Name:LYNN LORIS OWENS, PSYD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:LORIS
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-309-7055
Mailing Address - Street 1:10015 OLD COLUMBIA RD
Mailing Address - Street 2:SUITE B-215
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1703
Mailing Address - Country:US
Mailing Address - Phone:410-309-7055
Mailing Address - Fax:410-290-5285
Practice Address - Street 1:10015 OLD COLUMBIA RD
Practice Address - Street 2:SUITE B-215
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1703
Practice Address - Country:US
Practice Address - Phone:410-309-7055
Practice Address - Fax:410-290-5285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04825103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty