Provider Demographics
NPI:1194132753
Name:LAMB, GLORIA DELORES (DR OF PHILOSAPHY)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:DELORES
Last Name:LAMB
Suffix:
Gender:F
Credentials:DR OF PHILOSAPHY
Other - Prefix:MRS
Other - First Name:GLORIA
Other - Middle Name:DELORES
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1545 CROSSWAYS BLVD
Mailing Address - Street 2:SUITE 265
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-777-3955
Mailing Address - Fax:751-777-3955
Practice Address - Street 1:1545 CROSSWAYS BLVD
Practice Address - Street 2:SUITE 265
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-777-3955
Practice Address - Fax:751-777-3955
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABUS:05896251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health