Provider Demographics
NPI:1992951669
Name:HAMBURG, ELLEN MARION (M S CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MARION
Last Name:HAMBURG
Suffix:
Gender:F
Credentials:M S CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 MARQUETTE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4310
Mailing Address - Country:US
Mailing Address - Phone:713-660-0487
Mailing Address - Fax:
Practice Address - Street 1:8323 SW FWY
Practice Address - Street 2:SUITE NUMBER 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1615
Practice Address - Country:US
Practice Address - Phone:713-772-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist