Provider Demographics
NPI:1447248950
Name:O'CONNOR, LYNN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:MARIE
Last Name:O'CONNOR
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 1:50 LARNED LN
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2306
Mailing Address - Country:US
Mailing Address - Phone:716-479-0150
Mailing Address - Fax:
Practice Address - Street 1:50 LARNED LN
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2306
Practice Address - Country:US
Practice Address - Phone:716-662-5914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010931-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical