1821454521 NPI number — HOLLEE ANNE HUDNELL LYNN MS, LPC, AADC,ICAADC

Table of content: HOLLEE ANNE HUDNELL LYNN MS, LPC, AADC,ICAADC (NPI 1821454521)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821454521 NPI number — HOLLEE ANNE HUDNELL LYNN MS, LPC, AADC,ICAADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNN
Provider First Name:
HOLLEE
Provider Middle Name:
ANNE HUDNELL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC, AADC,ICAADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALMER
Provider Other First Name:
HOLLEE
Provider Other Middle Name:
ANNE HUDNELL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1821454521
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOTHAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36302-1245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-712-6400
Provider Business Mailing Address Fax Number:
334-712-2673

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1672 COLUMBIA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36303-5434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-712-6400
Provider Business Practice Location Address Fax Number:
334-712-2673
Provider Enumeration Date:
01/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  3445 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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