Provider Demographics
NPI:1356667182
Name:HAMMONS, HEATHER LYNN (BHRS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-0711
Mailing Address - Country:US
Mailing Address - Phone:918-647-4196
Mailing Address - Fax:918-647-5741
Practice Address - Street 1:320 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4212
Practice Address - Country:US
Practice Address - Phone:918-647-4196
Practice Address - Fax:918-647-5741
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst