Provider Demographics
NPI:1720258346
Name:HAMMOND, ANGELA (MS, SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1930
Mailing Address - Country:US
Mailing Address - Phone:843-686-5556
Mailing Address - Fax:
Practice Address - Street 1:120 LAMOTTE DR
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2792
Practice Address - Country:US
Practice Address - Phone:843-415-5883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006269235Z00000X
SC2785235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist