Provider Demographics
NPI:1043745573
Name:OR, JUSTINA MEI LAM (PHD, PSYD)
Entity type:Individual
Prefix:DR
First Name:JUSTINA
Middle Name:MEI LAM
Last Name:OR
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:DR
Other - First Name:MEI LAM JUSTINA
Other - Middle Name:
Other - Last Name:OR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 MDG
Mailing Address - Street 2:UNIT 5268
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18 MDG UNIT 5268
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5217
Practice Address - Country:US
Practice Address - Phone:315-634-3272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
VA0810009052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator