Provider Demographics
NPI:1336368000
Name:LAMBERT, RENEL LISA (OTR)
Entity Type:Individual
Prefix:
First Name:RENEL
Middle Name:LISA
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 RAINER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1937
Mailing Address - Country:US
Mailing Address - Phone:610-490-0143
Mailing Address - Fax:610-490-0143
Practice Address - Street 1:2507 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4841
Practice Address - Country:US
Practice Address - Phone:610-872-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003049L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist