| Judy N. Lam, Ph.d., Pllc | |
|
2409 N 21st St Boise ID 83702-0508 | |
| (208) 283-0628 | |
| (208) 209-2388 |
| Full Name | Judy N. Lam, Ph.d., Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2409 N 21st St, Boise, Idaho |
| Authorized Official Name and Position | Judy N. Lam (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2082830628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judy N. Lam, Ph.d., Pllc 2409 N 21st St Boise ID 83702-0508 Ph: (208) 283-0628 | Judy N. Lam, Ph.d., Pllc 2409 N 21st St Boise ID 83702-0508 Ph: (208) 283-0628 |
| NPI Number | 1205066198 |
|---|---|
| Provider Enumeration Date | 07/26/2009 |
| Last Update Date | 01/21/2021 |
| Certification Date | 01/16/2021 |
| Medicare PECOS PAC ID | 2860546751 |
|---|---|
| Medicare Enrollment ID | O20090811000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205066198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY 202366 (Idaho) | Primary |
| Provider Name | Judy Lam |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831131945 PECOS PAC ID: 0143207944 Enrollment ID: I20090811000672 |
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