Provider Demographics
NPI:1922121896
Name:HAMMOND, STEPHANIE KATHERINE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:KATHERINE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14834 N ALAMOSA CIR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2508
Mailing Address - Country:US
Mailing Address - Phone:480-836-4482
Mailing Address - Fax:
Practice Address - Street 1:16000 E PALISADES BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3131
Practice Address - Country:US
Practice Address - Phone:480-664-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP0796OtherAZ STATE SLP LICENSURE
AZ478405OtherAHCCCS