Provider Demographics
NPI:1043768948
Name:LYNN, CHRYSTAL R
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:R
Last Name:LYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 CHARLES HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1667
Mailing Address - Country:US
Mailing Address - Phone:901-300-6663
Mailing Address - Fax:
Practice Address - Street 1:160 S HOLLYWOOD ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4801
Practice Address - Country:US
Practice Address - Phone:901-416-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist