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General NPI Number Information
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NPI Number | 1902357841
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Entity Type | Organization
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Legal Business Name | HAMER THERAPY CONSULTANTS LLC
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Dates
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Enumeration Date | 10/15/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 783 RISING STAR RD
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-3402
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Country | US
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Telephone | 662-544-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 PRIVATE ROAD 3097
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City | OXFORD
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State | MS
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Zip | 38655-7504
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Country | US
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Telephone | 662-544-0410
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Fax |
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Authorized Official
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Title or Position | CCC-SLP
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Name | WHITLEY D HAMER
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Credential | MS
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Telephone | 662-544-0410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S3813
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License Number State | MS
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