Provider Demographics
NPI:1861086159
Name:LAMB, BRANDY (MS, CGC)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:HENEFER
Mailing Address - State:UT
Mailing Address - Zip Code:84033-0066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5475 S 500 E
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6905
Practice Address - Country:US
Practice Address - Phone:801-479-2848
Practice Address - Fax:801-204-9830
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDGEN-259170300000X
UT10872595-3601170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS