=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831052885
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILEE CECELIA LAM M.S., CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2025
-----------------------------------------------------
Last Update Date | 12/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5301 PROVIDENCE RD STE 90
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23464-4128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-467-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5301 PROVIDENCE RD STE 90
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23464-4128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-467-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 2202012218
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------