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General NPI Number Information
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NPI Number | 1487010120
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Entity Type | Individual
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Provider Name | COLLEEN MARIE LAMBERT
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Gender | Female
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 17937 HALL RD
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City | MACOMB
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State | MI
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Zip | 48044-4557
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Country | US
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Telephone | 586-764-0536
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Fax |
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Provider Business Mailing Address
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Address Line | 24600 URSULINE ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-3191
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Country | US
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Telephone | 586-764-0536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014568
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License Number State | MI
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