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General NPI Number Information
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NPI Number | 1235718180
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Entity Type | Individual
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Provider Name | MORIAH L. HAMMOCK M. ED., BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 8735 OLD BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40291
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Country | US
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Telephone | 757-455-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 4977 VETERANS MEMORIAL HWY APT 7
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City | BROWNSVILLE
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State | KY
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Zip | 42210-8404
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Country | US
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Telephone | 325-812-1873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 286230
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License Number State | KY
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