Provider Demographics
NPI:1205670239
Name:LAMB, MADISON ARLENE (CF-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ARLENE
Last Name:LAMB
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N MISSION PARK BLVD APT 2060
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3997
Mailing Address - Country:US
Mailing Address - Phone:602-592-1334
Mailing Address - Fax:
Practice Address - Street 1:3200 N DOBSON RD BLDG E
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9601
Practice Address - Country:US
Practice Address - Phone:480-935-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP15361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist