Provider Demographics
NPI:1477809465
Name:LAMB, BRANDY NICOLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:NICOLE
Last Name:LAMB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-9326
Mailing Address - Country:US
Mailing Address - Phone:208-412-0203
Mailing Address - Fax:
Practice Address - Street 1:10716 LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-9326
Practice Address - Country:US
Practice Address - Phone:208-412-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-32288104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker