Individual
SHARON ROSA HAMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
770 N NICKLAUS LN, EAGLE, ID 83616-5358
(312) 965-0245
Mailing address
770 N NICKLAUS LN, EAGLE, ID 83616-5358
(312) 965-0245
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6611
ID
Other
Enumeration date
09/13/2017
Last updated
12/02/2020
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