Provider Demographics
NPI:1902360290
Name:LAMBRETH, SIERRA GRACE
Entity Type:Individual
Prefix:MS
First Name:SIERRA
Middle Name:GRACE
Last Name:LAMBRETH
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 1:1575 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2879
Mailing Address - Country:US
Mailing Address - Phone:469-744-0538
Mailing Address - Fax:
Practice Address - Street 1:8150 BROOKRIVER DR STE S110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-7205
Practice Address - Country:US
Practice Address - Phone:214-678-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist