Provider Demographics
NPI:1255473229
Name:HAMBRECHT, GEORGIA (SLP-CCC SP)
Entity Type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:
Last Name:HAMBRECHT
Suffix:
Gender:F
Credentials:SLP-CCC SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G 30 MCKEE
Mailing Address - Street 2:
Mailing Address - City:CULLLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723
Mailing Address - Country:US
Mailing Address - Phone:828-227-3279
Mailing Address - Fax:828-227-7456
Practice Address - Street 1:G 30 MCKEE
Practice Address - Street 2:
Practice Address - City:CULLLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-227-3279
Practice Address - Fax:828-227-7456
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22003016A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412194Medicaid