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Individual
MR. SHANE HAMILTON
Active
Individual
MR. SHANE HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW-PIP
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3140
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144554296
—
MN
05
—
1144554296
—
SD
Enumeration date
09/22/2009
Last updated
04/08/2014
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