Provider Information for 1164978565
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TUNISIA LYNNE LUMPFORD LCSWA
Sex: Female
NPI: 1164978565
Last Updated: 2023-08-01
Certification Date: 2023-08-01
Certification Date: 2023-08-01
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164978565 | ||||||||||||||
| Enumeration Date | 2016-08-26 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 827 CREEK CROSSING TRL WHITSETT, NC 27377-9259 United States Phone: 336-447-1714 | Fax: | ||||||||||||||
| Primary Practice Address | 1600 E WENDOVER AVE GREENSBORO, NC 27405-6871 United States Phone: 336-408-8865 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 200 HAWTHORNE LN | ||||||||||||||
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