MEDICARE: ASHLEY GRAHAM HAMMOCK MCD CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	3774	AL

General Provider Information

NPI Number	:	1487204269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY GRAHAM HAMMOCK MCD CCC-SLP

Provider Business Mailing Address
First Line	:	1000 KINGSTON DR
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35151-6156
Country	:	US
Telephone Number	:	205-753-5536
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 W SPRING ST STE 101
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2974
Country	:	US
Telephone Number	:	256-401-4662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	09/13/2019

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Directions to “ ASHLEY GRAHAM HAMMOCK MCD CCC-SLP” Practice Location

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