Basic Information
| Provider Information | |||||||||
| NPI: | 1548691439 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMACK | ||||||||
| FirstName: | GARAH | ||||||||
| MiddleName: | MARIA | ||||||||
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| Credential: | LAMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5350 SUMMIT BRIDGE RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197094802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026050577 | ||||||||
| FaxNumber: | 7074259880 | ||||||||
| Practice Location | |||||||||
| Address1: | 1058 S GOVERNORS AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199046920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023828698 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2013 | ||||||||
| LastUpdateDate: | 04/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | FA-0000016 | DE | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 2016-032A | ND | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | FT-0000053 | DE | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.