Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | PSY-1018 | HI |
Y | 103G00000X | Clinical Psychologist | PSY-1018 | HI |
Y | 103TC0700X | Clinical Psychologist | PSY-1018 | HI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY-1018 | HI |
N | 103TF0000X | Family Psychologist | PSY-1018 | HI |
NPI | 1073774741 |
---|---|
Provider Name | Dr. Ihan Lam |
First Address | Apo, AP 96251-0014 |
Second Address | Apo, AP 96271 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 07/02/2020 |