Provider Demographics
NPI:1407132269
Name:LAMBERT, VIOLA IRENE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VIOLA
Middle Name:IRENE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MO
Mailing Address - Zip Code:63459-1301
Mailing Address - Country:US
Mailing Address - Phone:573-231-2586
Mailing Address - Fax:
Practice Address - Street 1:951 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-1112
Practice Address - Country:US
Practice Address - Phone:636-462-5218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2018-06-20
Deactivation Date:2017-04-13
Deactivation Code:
Reactivation Date:2018-06-20
Provider Licenses
StateLicense IDTaxonomies
MO2011019588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist