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Individual

AMY FATHEREE LAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1800 ROSE ST, WICHITA FALLS, TX 76301-4219
(940) 322-2372
(940) 322-3578
Mailing address
1808 ROSE ST, WICHITA FALLS, TX 76301-4219
(940) 322-2372
(940) 322-3578

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
59337
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
183462401
TX
01
7494LC
BCBS
TX
01
9469128
PHCS
TX
01
9603074
AETNA BEHAVIORAL HEALTH
TX
Enumeration date
02/27/2007
Last updated
10/09/2012
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