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Individual

ANGELA HAMMOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2990
Mailing address
21383 N 79TH DR, PEORIA, AZ 85382-4448

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
583733
AHCCCS
AZ
Enumeration date
02/01/2007
Last updated
07/08/2007
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