Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC002993 |
NPI | 1003437849 |
---|---|
Provider Name | Susan Lambert |
First Address | Berwyn, PA 19312-1928 |
Second Address | Philadelphia, PA 19131-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2020 |
Last Update Date | 04/05/2020 |