Provider Demographics
NPI:1699412460
Name:LAMP, CHARITY MELISSA
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:MELISSA
Last Name:LAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 KATAHDIN DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1872
Mailing Address - Country:US
Mailing Address - Phone:443-851-7995
Mailing Address - Fax:
Practice Address - Street 1:5805 KATAHDIN DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-1872
Practice Address - Country:US
Practice Address - Phone:443-851-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician