Provider Demographics
NPI:1043745573
Name:OR, JUSTINA MEI LAM (PHD)
Entity type:Individual
Prefix:DR
First Name:JUSTINA
Middle Name:MEI LAM
Last Name:OR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 HEALTH SCIENCES BLDG 3640 COLONEL GLENN HWY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45435-0001
Mailing Address - Country:US
Mailing Address - Phone:937-775-3458
Mailing Address - Fax:
Practice Address - Street 1:117 HEALTH SCIENCES BLDG 3640 COLONEL GLENN HWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45435-4667
Practice Address - Country:US
Practice Address - Phone:937-775-3458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator