MEDICARE: KRISTINA DIANE HAMMOND M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP 0000004725	TN

General Provider Information

NPI Number	:	1891056602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA DIANE HAMMOND M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	220 TOWN CENTER PKWY
Second Line	:	SUITE 204
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4407
Country	:	US
Telephone Number	:	615-416-1418
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 TOWN CENTER PKWY
Second Line	:	SUITE 204
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4407
Country	:	US
Telephone Number	:	615-416-1418
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	08/07/2012

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