Provider Demographics
NPI:1407917578
Name:LAMBRECHT, JEANE MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEANE
Middle Name:MARIE
Last Name:LAMBRECHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 W GANDY BLVD
Mailing Address - Street 2:UNIT B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-2856
Mailing Address - Country:US
Mailing Address - Phone:602-369-7788
Mailing Address - Fax:
Practice Address - Street 1:6TH MEDICAL OPERATIONS SQ SGOMA
Practice Address - Street 2:8415 BAYSHORE BLVD
Practice Address - City:MACDILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-828-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3829103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical