MEDICARE: DONNA LAMB LCSW PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1659980803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONNA LAMB LCSW PLLC

Provider Business Mailing Address
First Line	:	491 CYPRESS ESTATES PARKWAY
Second Line	:
City	:	INGRAM
State	:	TX
Zip	:	78025
Country	:	US
Telephone Number	:	713-295-1695
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 SIDNEY BAKER ST S STE 350
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5900
Country	:	US
Telephone Number	:	830-257-0022
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONNA LAMB
Credential	:	LCSW
Telephone Number	:	713-295-1695

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	07/23/2020

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