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Individual

MR. SHANE HAMILTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSW-PIP

Contact information

Practice address
6101 S LOUISE AVE, SIOUX FALLS, SD 57108
(605) 312-8000
(605) 312-8001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512

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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