Provider Demographics
NPI:1639663065
Name:LAMB, MARTHA HARDY
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:HARDY
Last Name:LAMB
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 1:7 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1403
Mailing Address - Country:US
Mailing Address - Phone:781-856-2433
Mailing Address - Fax:
Practice Address - Street 1:7 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1403
Practice Address - Country:US
Practice Address - Phone:781-856-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1432103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling