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NPI Code Detail

MEDICARE: ELLIE KRISTINE LAMBERT

MEDICARE: ELLIE KRISTINE LAMBERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1225864846
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIE KRISTINE LAMBERT
Provider Business Mailing Address
First Line : 75 E FORT UNION BLVD STE C118
Second Line :
City : MIDVALE
State : UT
Zip : 84047-5512
Country : US
Telephone Number : 801-792-4867
Fax Number :
Provider Business Practice Location Address
First Line : 75 E FORT UNION BLVD STE C118
Second Line :
City : MIDVALE
State : UT
Zip : 84047-5512
Country : US
Telephone Number : 801-792-4867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2024
Last Update Date : 09/10/2024

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Directions to “ ELLIE KRISTINE LAMBERT ” Practice Location

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