Individual
ANDREA HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
276 GRAYLYN CREST DR, NEW COLUMBIA, PA 17856-9418
(570) 490-3017
Mailing address
276 GRAYLYN CREST DR, NEW COLUMBIA, PA 17856-9418
(570) 523-6787
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002424
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH002424
BEHAVIOR SPECIALIST LICENSE
PA
Enumeration date
08/23/2018
Last updated
08/23/2018
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