Provider Demographics
NPI:1427225531
Name:LAMB, MICHELLE CHRISTINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CHRISTINE
Last Name:LAMB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 BENTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8185
Mailing Address - Country:US
Mailing Address - Phone:317-837-8075
Mailing Address - Fax:
Practice Address - Street 1:202 MYERS RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-9702
Practice Address - Country:US
Practice Address - Phone:317-718-8436
Practice Address - Fax:317-718-8438
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040991A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400061339Medicare PIN