Provider Demographics
NPI:1396064606
Name:HAMMOND, EMMANUEL (MS, US)
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:MS, US
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3410
Mailing Address - Country:US
Mailing Address - Phone:405-401-2168
Mailing Address - Fax:
Practice Address - Street 1:4420 N LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-5104
Practice Address - Country:US
Practice Address - Phone:405-525-0452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health