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General NPI Number Information
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NPI Number | 1235508482
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Entity Type | Organization
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Legal Business Name | LAMBERT THERAPY SERVICES OF PICAYUNE, LLC
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 317 N MAIN ST
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City | PICAYUNE
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State | MS
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Zip | 39466-3313
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Country | US
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Telephone | 769-926-2441
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Fax | 769-926-2442
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Provider Business Mailing Address
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Address Line | 317 N MAIN ST
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City | PICAYUNE
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State | MS
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Zip | 39466-3313
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Country | US
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Telephone | 769-926-2441
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Fax | 769-926-2442
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MARCELLA A BEACH
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Credential | RN
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Telephone | 769-926-2441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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