=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548470750
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA LYNN LAMSON PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 612 E 10TH ST EAST CAROLINA UNIVERSITY
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-3411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-737-2042
-----------------------------------------------------
Fax | 252-328-4276
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 BRYANT CIR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-9782
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-737-2042
-----------------------------------------------------
Fax | 252-321-2146
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 838
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------