Provider Demographics
NPI:1952937310
Name:LAMBERT, TAMMY LYNN (ADT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8093 SOLLEY RD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8610
Mailing Address - Country:US
Mailing Address - Phone:410-972-8924
Mailing Address - Fax:
Practice Address - Street 1:69 SHERRY LN
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3231
Practice Address - Country:US
Practice Address - Phone:434-968-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT1536101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)