Healthcare Provider Details

I. General information

NPI: 1902153117
Provider Name (Legal Business Name): RUTHIE LAMB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S BROADWAY AVE SUITE 106
ADA OK
74820-5828
US

IV. Provider business mailing address

PO BOX 662
PURCELL OK
73080-0662
US

V. Phone/Fax

Practice location:
  • Phone: 580-235-0210
  • Fax: 580-235-0211
Mailing address:
  • Phone: 405-527-1785
  • Fax: 405-527-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: