Healthcare Provider Details

I. General information

NPI: 1134065659
Provider Name (Legal Business Name): LYNN HAMMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 17TH AVE
BLOOMER WI
54724-1573
US

IV. Provider business mailing address

1310 17TH AVE
BLOOMER WI
54724-1573
US

V. Phone/Fax

Practice location:
  • Phone: 715-568-2800
  • Fax:
Mailing address:
  • Phone: 715-568-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09109086
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: