| Doctor Name: | MS. JACKIE HAMMELMAN |
| NPI Number: | 1063858546 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD CLINICAL PSYCHOL |
| License Number: | |
| Business Practice Address: | 2817 Reilly Road Bldg 4-3219 Womack Army Medical Center Service Member Behavioral He Ft. Bragg, NC - 283107301 |
| Business Phone Number: | 9542889535 |
| Business Fax Number: | |
| Mailing Address: | 2817 Reilly Road Bldg 4-3219, Service Member Behavioral Health Womack Army Medical Ce FT BRAGG |
| State: | NC |
| Postal Code: | 283107301 |
| Phone Number: | 9109079486 |
| Fax Number: | 9109072625 |
| NPI Enumeration Date: | 05/10/2013 |
| NPI Last Update Date: | 05/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |