MEDICARE: LESA ANN LAMB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	104117	TX
2	225XP0200X	Pediatric Occupational Therapist	104117	TX
3	225XH1200X	Hand Occupational Therapist	3747	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8T6895	OTHER	TX	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528153046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESA ANN LAMB

Provider Business Mailing Address
First Line	:	1515 AQUABELLE LN UNIT 6303
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8185
Country	:	US
Telephone Number	:	512-784-5331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1445 BLUEWATER WAY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-7923
Country	:	US
Telephone Number	:	843-576-9667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/23/2026

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Directions to “ LESA ANN LAMB ” Practice Location

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