Provider Demographics
NPI:1801325907
Name:HAMBLY, CATHERINE LYNN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LYNN
Last Name:HAMBLY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3197 WESTCLIFF RD W
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-2129
Mailing Address - Country:US
Mailing Address - Phone:409-771-2065
Mailing Address - Fax:
Practice Address - Street 1:5701 EDWARDS RANCH RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4116
Practice Address - Country:US
Practice Address - Phone:817-377-1254
Practice Address - Fax:682-316-4515
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist