Provider Demographics
NPI:1710117262
Name:LAMB, JUDY D (PHD, MSCP)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:D
Last Name:LAMB
Suffix:
Gender:F
Credentials:PHD, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PLAZA PLACE STE 300
Mailing Address - Street 2:PMB1022
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:619-356-0279
Mailing Address - Fax:
Practice Address - Street 1:100 PLAZA PLACE STE 300
Practice Address - Street 2:PMB1022
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76226
Practice Address - Country:US
Practice Address - Phone:619-356-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-18
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28244103T00000X
ID203649103T00000X
TX39571103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist