Basic Information
| Provider Information | |||||||||
| NPI: | 1629576962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMOND | ||||||||
| FirstName: | REBEKAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5511 EDMONDSON PIKE STE 105 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372116852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155644984 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3055 LEBANON PIKE STE 2100 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372142246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2054908228 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2018 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-17-27104 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | 1-17-27104 | 01 | BCBA | OTHER |