Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | LP2062 | MN |
Y | 103T00000X | Psychologist | LP2062 | MN |
NPI | 1003809740 |
---|---|
Provider Name | Ms. Sharon Grace Lamb |
First Address | Saint Paul, MN 55104-6942 |
Second Address | Saint Paul, MN 55104-6942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
63675WI | BCBS (01) | |
818250700 | (05) | MN |
N009689 | CHAMPUS (01) |