Provider Demographics
NPI:1780829556
Name:MELTZER, LYNN JOAN (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:JOAN
Last Name:MELTZER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INSTITUTE FOR LEARNING AND DEVELOPMENT
Mailing Address - Street 2:4 MILITIA DRIVE
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421
Mailing Address - Country:US
Mailing Address - Phone:781-861-3711
Mailing Address - Fax:
Practice Address - Street 1:INSTITUTE FOR LEARNING AND DEVELOPMENT
Practice Address - Street 2:4 MILITIA DRIVE
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421
Practice Address - Country:US
Practice Address - Phone:781-861-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3005103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist