Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 916 PSY HEALTH SERVI | MA |
Y | 103TC0700X | Clinical Psychologist | 916 PSY HEALTH SERVI | MA |
NPI | 1013083021 |
---|---|
Provider Name | Dr. Jessica Ellen Hammann |
First Address | Weston, MA 02493-1161 |
Second Address | Weston, MA 02493-1161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 09/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051572000 | MAGELLAN BEHAVIORAL HEALT (01) | |
411624 | TUFTS (01) | MA |
W01447 | (02) | |
W01447 | BLUE CROSS BLUE SHIELD (01) | MA |