Provider Demographics
NPI:1700037058
Name:LAMMERS-HASHEM, FARDOUS (MS IMT)
Entity Type:Individual
Prefix:MRS
First Name:FARDOUS
Middle Name:
Last Name:LAMMERS-HASHEM
Suffix:
Gender:F
Credentials:MS IMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N HIGHWAY 27 UNIT B
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2431
Mailing Address - Country:US
Mailing Address - Phone:352-536-2364
Mailing Address - Fax:352-536-2370
Practice Address - Street 1:221 N HIGHWAY 27 UNIT B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2431
Practice Address - Country:US
Practice Address - Phone:352-536-2364
Practice Address - Fax:352-536-2370
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist