Provider Demographics
NPI:1316003494
Name:LAMM & ASSOCIATES PEDIATRIC THERAPY, INC
Entity Type:Organization
Organization Name:LAMM & ASSOCIATES PEDIATRIC THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-349-0169
Mailing Address - Street 1:4622 BERWYN LN
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8252
Mailing Address - Country:US
Mailing Address - Phone:610-349-0169
Mailing Address - Fax:610-366-7455
Practice Address - Street 1:4622 BERWYN LN
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8252
Practice Address - Country:US
Practice Address - Phone:610-349-0169
Practice Address - Fax:610-366-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-31
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLO007416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016600450001Medicaid
PA1016600090001Medicaid
PA0019701700003Medicaid