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General NPI Number Information
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NPI Number | 1902050438
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Entity Type | Individual
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Provider Name | JACINDA C HAMMEL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 1760 S RAMSEY DR
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City | BLOOMINGTON
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State | IN
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Zip | 47401-7179
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Country | US
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Telephone | 205-336-1098
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Fax | 205-855-0992
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Provider Business Mailing Address
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Address Line | 1760 S RAMSEY DR
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City | BLOOMINGTON
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State | IN
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Zip | 47401-7179
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Country | US
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Telephone | 205-336-1098
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Fax | 205-855-0992
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1465
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043605A
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License Number State | IN
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