Provider Demographics
NPI:1730747882
Name:HAMMONDS, LAQNDA SHATASHIA
Entity type:Individual
Prefix:
First Name:LAQNDA
Middle Name:SHATASHIA
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 S OAKLAND ST STE A
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0474
Mailing Address - Country:US
Mailing Address - Phone:980-216-6899
Mailing Address - Fax:
Practice Address - Street 1:813 S OAKLAND ST STE A
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0474
Practice Address - Country:US
Practice Address - Phone:980-216-6899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0134771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical