Provider Demographics
NPI:1053768747
Name:STEPHANIE HAMILTON
Entity type:Organization
Organization Name:STEPHANIE HAMILTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:484-716-0359
Mailing Address - Street 1:509 WINDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9811
Mailing Address - Country:US
Mailing Address - Phone:484-716-0359
Mailing Address - Fax:
Practice Address - Street 1:509 WINDY HILL RD
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9811
Practice Address - Country:US
Practice Address - Phone:484-716-0359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health