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1902360290 NPI number — MS. SIERRA GRACE LAMBRETH

NPI Number: 1902360290
Health Care Provider/Practitioner: MS. SIERRA GRACE LAMBRETH

Information about “1902360290” NPI (MS. SIERRA GRACE LAMBRETH) exists in 1902360290 in HTML format HTML  |  1902360290 in plain Text format TXT  |  1902360290 in PDF (Portable Document Format) PDF  |  1902360290 in an XML format XML  formats.

NPI Number : 1902360290 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902360290",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAMBRETH",
    "FirstName": "SIERRA",
    "MiddleName": "GRACE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1575 FAIRVIEW DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCKWALL",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75087-2879",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "469-744-0538",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8150 BROOKRIVER DR STE S110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75247-7205",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-678-0507",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/30/2019",
    "LastUpdateDate": "01/30/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "115130",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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