Individual
DONTAE L HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
664 MARKLE AVE, PONTIAC, MI 48340-3023
(502) 991-1010
Mailing address
664 MARKLE AVE, PONTIAC, MI 48340-3023
(502) 991-1010
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
12/30/2021
Last updated
12/04/2024
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