Healthcare Provider Details

I. General information

NPI: 1871336495
Provider Name (Legal Business Name): ADRIA LAMB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3124 COLORADO LN
BISMARCK ND
58503-5447
US

IV. Provider business mailing address

PO BOX 13238
GRAND FORKS ND
58208-3238
US

V. Phone/Fax

Practice location:
  • Phone: 701-390-1313
  • Fax:
Mailing address:
  • Phone: 701-390-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3074
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: