Provider Demographics
NPI:1932829256
Name:LAM, JULIE R
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:LAM
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 1:9863 CABLE LINE RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND
Mailing Address - State:OH
Mailing Address - Zip Code:44412-9714
Mailing Address - Country:US
Mailing Address - Phone:330-606-7645
Mailing Address - Fax:
Practice Address - Street 1:9863 CABLE LINE RD
Practice Address - Street 2:
Practice Address - City:DIAMOND
Practice Address - State:OH
Practice Address - Zip Code:44412-9714
Practice Address - Country:US
Practice Address - Phone:330-606-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty