Healthcare Provider Details

I. General information

NPI: 1194190181
Provider Name (Legal Business Name): HUGH J. HAMMANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 ARNOLD PALMER CT
LAS CRUCES NM
88011-3902
US

IV. Provider business mailing address

1307 ARNOLD PALMER CT
LAS CRUCES NM
88011-3902
US

V. Phone/Fax

Practice location:
  • Phone: 585-455-7160
  • Fax:
Mailing address:
  • Phone: 585-455-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1179
License Number StateNM

VIII. Authorized Official

Name: DR. HUGH J HAMMANT
Title or Position: OWNER
Credential: PH.D.
Phone: 530-521-5610