Provider Demographics
NPI:1134564594
Name:HAMM-DOTSON, CHERYLYNN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CHERYLYNN
Middle Name:
Last Name:HAMM-DOTSON
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4438
Mailing Address - Country:US
Mailing Address - Phone:512-653-2588
Mailing Address - Fax:
Practice Address - Street 1:8304 WEXFORD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4438
Practice Address - Country:US
Practice Address - Phone:512-653-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT037905225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist