Provider Demographics
NPI:1275615536
Name:HAMM, ELENA CLAIRE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:CLAIRE
Last Name:HAMM
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HILLCREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-4156
Mailing Address - Country:US
Mailing Address - Phone:203-267-5796
Mailing Address - Fax:203-267-5796
Practice Address - Street 1:385 MAIN STREET
Practice Address - Street 2:SUITE 212
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-4156
Practice Address - Country:US
Practice Address - Phone:203-262-4603
Practice Address - Fax:203-262-4603
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist