Provider Demographics
NPI:1053507012
Name:LAZARUS, SHULAMIT (PHD)
Entity type:Individual
Prefix:MS
First Name:SHULAMIT
Middle Name:
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6005
Mailing Address - Country:US
Mailing Address - Phone:919-313-3113
Mailing Address - Fax:919-400-0191
Practice Address - Street 1:3017 PICKETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6005
Practice Address - Country:US
Practice Address - Phone:919-313-3113
Practice Address - Fax:919-400-0191
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist