Provider Demographics
NPI:1720622277
Name:HAMMOND, KRISTEN (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S MELVILLE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4524
Mailing Address - Country:US
Mailing Address - Phone:215-617-4363
Mailing Address - Fax:
Practice Address - Street 1:3580 INDIAN QUEEN LN STE 201
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1540
Practice Address - Country:US
Practice Address - Phone:215-617-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health