Blackburn, Lynn A.

Blackburn, Lynn A. is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Blackburn, Lynn A. can be contacted via phone (414) 805-3666.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-3666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PYR0372 Missouri
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2664 Wisconsin

Profile Details

NPI number 1619994670
LBN Legal business name Blackburn, Lynn A.
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Oct 12th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619994670 NPPES
Wisconsin MEDICAID 39074700
Wisconsin Other 6154255

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