Provider Demographics
NPI:1184818726
Name:HAMMONDS, TRINA L (PHD)
Entity Type:Individual
Prefix:MS
First Name:TRINA
Middle Name:L
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-1142
Mailing Address - Country:US
Mailing Address - Phone:404-369-6136
Mailing Address - Fax:678-818-4619
Practice Address - Street 1:619 MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:GA
Practice Address - Zip Code:30268-1142
Practice Address - Country:US
Practice Address - Phone:404-369-6136
Practice Address - Fax:678-818-4619
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003292101YP2500X
GA168421101YS0200X
GA003292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty