Provider Demographics
NPI:1487819868
Name:LAMBRECHT, MARY J (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:LAMBRECHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 GROGANS MILL RD
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3621
Mailing Address - Country:US
Mailing Address - Phone:281-466-8602
Mailing Address - Fax:281-466-8605
Practice Address - Street 1:9201 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3621
Practice Address - Country:US
Practice Address - Phone:281-466-8602
Practice Address - Fax:281-466-8605
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI634124106H00000X
TX201729106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43584300Medicaid