Provider Demographics
NPI:1215384649
Name:LAMB, HEATHER GEDDINGS (SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GEDDINGS
Last Name:LAMB
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:GEDDINGS
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:165 WHITEHALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 CLYDE JONES RD
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MD
Practice Address - Zip Code:20689-9684
Practice Address - Country:US
Practice Address - Phone:443-550-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLPSPTMP5070235Z00000X
MD09237235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist