MEDICARE: MS. CINDA LOU LAMAR MS, LCSW

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	3621-123	WI

General Provider Information

NPI Number	:	1902088933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CINDA LOU LAMAR MS, LCSW

Provider Business Mailing Address
First Line	:	6402 ODANA RD
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1123
Country	:	US
Telephone Number	:	608-273-4411
Fax Number	:

Provider Business Practice Location Address
First Line	:	6402 ODANA RD
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1123
Country	:	US
Telephone Number	:	608-273-4411
Fax Number	:

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

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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