Basic Information
Provider Information
NPI: 1003153552
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMAN
FirstName: SARAH
MiddleName: RENE
NamePrefix: DR.
NameSuffix:  
Credential: AU.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1818 MICCOSUKEE COMMONS DR
Address2: STE. 1
City: TALLAHASSEE
State: FL
PostalCode: 323085490
CountryCode: US
TelephoneNumber: 8505534327
FaxNumber:  
Practice Location
Address1: 1818 MICCOSUKEE COMMONS DR
Address2: STE. 1
City: TALLAHASSEE
State: FL
PostalCode: 323085490
CountryCode: US
TelephoneNumber: 8505534327
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/03/2013
LastUpdateDate: 01/03/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAY1638FLY Speech, Language and Hearing Service ProvidersAudiologist 
231H00000XAUD003863GAN Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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