Provider Demographics
NPI:1013292408
Name:RAMBADT, PATRICIA (MS CCC/LSP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:RAMBADT
Suffix:
Gender:F
Credentials:MS CCC/LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2127
Mailing Address - Country:US
Mailing Address - Phone:631-924-2969
Mailing Address - Fax:
Practice Address - Street 1:4130 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-679-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06529-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist