Provider Demographics
NPI:1366869174
Name:LAMB, NORAIDA
Entity Type:Individual
Prefix:
First Name:NORAIDA
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORAIDA
Other - Middle Name:
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10755 DEVORE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-5537
Mailing Address - Country:US
Mailing Address - Phone:870-710-1998
Mailing Address - Fax:
Practice Address - Street 1:115 ORENDORFF AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-4634
Practice Address - Country:US
Practice Address - Phone:870-741-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 3726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist