Provider Demographics
NPI:1982439519
Name:HAMMONDS, JALEEL
Entity type:Individual
Prefix:
First Name:JALEEL
Middle Name:
Last Name:HAMMONDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 CAPITAL CLUB WAY APT 303
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-6123
Mailing Address - Country:US
Mailing Address - Phone:803-300-7592
Mailing Address - Fax:
Practice Address - Street 1:1437 ELKO ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:SC
Practice Address - Zip Code:29853-6033
Practice Address - Country:US
Practice Address - Phone:803-300-7592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician