Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 3505 | SC |
NPI | 1427177716 |
---|---|
Provider Name | Thomas Anthony Hammill JR. |
First Address | Lexington, SC 29072 |
Second Address | Lexington, SC 29072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |