Provider Demographics
NPI:1548624505
Name:WEBB, AMBER C (CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:C
Last Name:WEBB
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 1:1211 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6493
Mailing Address - Country:US
Mailing Address - Phone:281-832-5155
Mailing Address - Fax:
Practice Address - Street 1:1211 WESLEY DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6493
Practice Address - Country:US
Practice Address - Phone:281-832-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist