Provider Demographics
NPI:1245674951
Name:LAMBERT, KRISTEN DIMARZO (MS SLP CCC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DIMARZO
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:DIMARZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:344 WEB FOOT LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2439
Mailing Address - Country:US
Mailing Address - Phone:410-562-0754
Mailing Address - Fax:
Practice Address - Street 1:344 WEB FOOT LN
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2439
Practice Address - Country:US
Practice Address - Phone:410-562-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist