Provider Demographics
NPI:1447590419
Name:HAMMOND, REBECCA LEIGH
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEIGH
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4552 ROCKLEDGE LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-9222
Mailing Address - Country:US
Mailing Address - Phone:386-341-3802
Mailing Address - Fax:
Practice Address - Street 1:4552 ROCKLEDGE LN
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9222
Practice Address - Country:US
Practice Address - Phone:386-341-3802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst