Provider Demographics
NPI:1326591314
Name:HAMMOND, MARY BETH (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 BOONES KNOB RD
Mailing Address - Street 2:
Mailing Address - City:ARGILLITE
Mailing Address - State:KY
Mailing Address - Zip Code:41121-9188
Mailing Address - Country:US
Mailing Address - Phone:859-608-1453
Mailing Address - Fax:
Practice Address - Street 1:127 BOONES KNOB RD
Practice Address - Street 2:
Practice Address - City:ARGILLITE
Practice Address - State:KY
Practice Address - Zip Code:41121-9188
Practice Address - Country:US
Practice Address - Phone:859-608-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY139747235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist