Provider Demographics
NPI:1144942962
Name:KILLIPS, LYNN (PSYD, MS, MA)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:KILLIPS
Suffix:
Gender:F
Credentials:PSYD, MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BLACKFIELD DR # 409
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2053
Mailing Address - Country:US
Mailing Address - Phone:415-964-2305
Mailing Address - Fax:
Practice Address - Street 1:130 NEIDER LN
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2474
Practice Address - Country:US
Practice Address - Phone:415-272-9928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist