Organization
HAMMOND SPEECH PATHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN HAMMOND M.S. (SPEECH/LANGUAGE PATHOLOGIST)
(208) 552-2374
Entity
Organization
Contact information
Practice address
1820 E 17TH ST, SUITE 270, IDAHO FALLS, ID 83404-6469
(208) 552-2374
(208) 524-0867
Mailing address
3696 S HOLMES AVE, IDAHO FALLS, ID 83404-7911
(208) 552-2374
(208) 524-0867
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP 1346
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000104470
REGENCE BLUE SHIELD
ID
05
—
808038900
—
ID
01
—
SPF07
BLUE CROSS
ID
Enumeration date
01/15/2010
Last updated
09/17/2014
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