Provider Demographics
NPI:1629576962
Name:HAMMOND, REBEKAH (MS, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:REBEKAH
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 EDMONDSON PIKE STE 105
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6852
Mailing Address - Country:US
Mailing Address - Phone:615-564-4984
Mailing Address - Fax:
Practice Address - Street 1:3055 LEBANON PIKE STE 2100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2246
Practice Address - Country:US
Practice Address - Phone:205-490-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-27104103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-27104OtherBCBA