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Individual

JENNIFER L LAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1376
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
089841
AZ
01
P00625135
RAILROAD MEDICARE
AZ
Enumeration date
04/25/2006
Last updated
11/19/2008
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