Provider Demographics
NPI:1629732375
Name:FEUERBERG, LYDIA ESTHER
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:ESTHER
Last Name:FEUERBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6809
Mailing Address - Country:US
Mailing Address - Phone:469-777-3906
Mailing Address - Fax:
Practice Address - Street 1:3152 HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6809
Practice Address - Country:US
Practice Address - Phone:469-777-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist