Healthcare Provider Details

I. General information

NPI: 1811751274
Provider Name (Legal Business Name): KELLY D HAMMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 07/23/2026
Certification Date: 02/08/2024
Deactivation Date: 01/17/2025
Reactivation Date: 07/23/2026

III. Provider practice location address

6501 N CHARLES ST
TOWSON MD
21204-6819
US

IV. Provider business mailing address

653 E CLEMENT ST
BALTIMORE MD
21230-4720
US

V. Phone/Fax

Practice location:
  • Phone: 410-938-3000
  • Fax:
Mailing address:
  • Phone: 908-334-3445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number08379
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: