Healthcare Provider Details

I. General information

NPI: 1730105842
Provider Name (Legal Business Name): REBECCA HAMMETT PSY.D., LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 RAYMOND AVE SUITE 270
SAINT PAUL MN
55114-1503
US

IV. Provider business mailing address

821 RAYMOND AVE SUITE 270
SAINT PAUL MN
55114-1503
US

V. Phone/Fax

Practice location:
  • Phone: 651-707-3020
  • Fax: 651-379-0993
Mailing address:
  • Phone: 651-707-3020
  • Fax: 651-379-0993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4522
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: