Individual
VICKI LYNN HAMMEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.,CCC-SP
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 448-8335
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002691A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000188253
ANTHEM PROVIDER NUMBER
IN
01
—
9397790
PHCS PID NUMBER
IN
Enumeration date
03/21/2006
Last updated
07/09/2007
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