Provider Demographics
NPI:1962636142
Name:HAMMAR, KRYSTAL
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:HAMMAR
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 1:2419 SMALLMAN ST.
Mailing Address - Street 2:UNIT 401
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222
Mailing Address - Country:US
Mailing Address - Phone:978-604-5112
Mailing Address - Fax:
Practice Address - Street 1:PA STATE BOARD OF SOCIAL WORKERS
Practice Address - Street 2:P.O. BOX 2649, HARRISBURG, PA 17105
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17105-2649
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker