Provider Demographics
NPI:1205114253
Name:LAMBECK, JESSICA RAE (SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:LAMBECK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E PEARL ST
Mailing Address - Street 2:
Mailing Address - City:GOLIAD
Mailing Address - State:TX
Mailing Address - Zip Code:77963-4200
Mailing Address - Country:US
Mailing Address - Phone:361-645-8229
Mailing Address - Fax:210-731-8678
Practice Address - Street 1:314 E PEARL ST
Practice Address - Street 2:
Practice Address - City:GOLIAD
Practice Address - State:TX
Practice Address - Zip Code:77963-4200
Practice Address - Country:US
Practice Address - Phone:361-645-8229
Practice Address - Fax:210-731-8678
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105971235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist