Provider Demographics
NPI:1396074001
Name:HAMMER, SHIRLEY JEAN (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:HAMMER
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BILLY FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:SUMMER SHADE
Mailing Address - State:KY
Mailing Address - Zip Code:42166-8643
Mailing Address - Country:US
Mailing Address - Phone:270-487-5328
Mailing Address - Fax:
Practice Address - Street 1:43 BILLY FERGUSON RD
Practice Address - Street 2:
Practice Address - City:SUMMER SHADE
Practice Address - State:KY
Practice Address - Zip Code:42166-8643
Practice Address - Country:US
Practice Address - Phone:270-487-5328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist