Individual
DR. MARYANNE GRANDE HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
760 PERINTON HILLS OFFICE PARK, FAIRPORT, NY 14450
(585) 223-5920
(585) 223-5727
Mailing address
1498 EAST AVE, ROCHESTER, NY 14610
(585) 442-3415
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
004209
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100140FC
PREFERRED CARE
NY
05
—
7408318
—
NY
Enumeration date
09/06/2006
Last updated
07/08/2007
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