Healthcare Provider Details

I. General information

NPI: 1285949909
Provider Name (Legal Business Name): TINOTHY PATRICK LAMBERT M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17999 W SURPRISE FARMS LOOP S
SURPRISE AZ
85388-6641
US

IV. Provider business mailing address

12518 W CANTERBURY DR
EL MIRAGE AZ
85335-6318
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-7350
  • Fax:
Mailing address:
  • Phone: 623-695-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: