Basic Information
| Provider Information | |||||||||
| NPI: | 1689930182 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOSIAD | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | HOPE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 JEFFERSON ST. | ||||||||
| Address2: | 2C | ||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173790496 | ||||||||
| FaxNumber: | 6178070958 | ||||||||
| Practice Location | |||||||||
| Address1: | 929 MASSACHUSETTS AVE. | ||||||||
| Address2: | STE. 103 | ||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173955806 | ||||||||
| FaxNumber: | 6175470003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2012 | ||||||||
| LastUpdateDate: | 03/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 9193 | MA | Y | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | 9193 | MA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.