Basic Information
Provider Information
NPI: 1255436416
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMBERT
FirstName: LYNN
MiddleName: OAKS
NamePrefix: MRS.
NameSuffix:  
Credential: M.S., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 309 YACHT CLUB DR NE
Address2:  
City: FORT WALTON BEACH
State: FL
PostalCode: 325486423
CountryCode: US
TelephoneNumber: 8502405951
FaxNumber: 8508626270
Practice Location
Address1: 2108 LEWIS TURNER BLVD
Address2:  
City: FORT WALTON BEACH
State: FL
PostalCode: 325471316
CountryCode: US
TelephoneNumber: 8508623728
FaxNumber: 8508626270
Other Information
ProviderEnumerationDate: 09/13/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSA 3077FLY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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