Provider Demographics
NPI:1306153911
Name:DELCAMBRE-THIGPEN, DEIRDRE (MS SLP)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:
Last Name:DELCAMBRE-THIGPEN
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 HIGHLAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-6031
Mailing Address - Country:US
Mailing Address - Phone:800-340-4098
Mailing Address - Fax:
Practice Address - Street 1:5550 HIGHLAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-6031
Practice Address - Country:US
Practice Address - Phone:800-340-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1062372355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207164901Medicaid
TX149984001Medicaid
TX456606Medicare PIN
TX676535Medicare PIN