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ANTOINETTE HAMIDIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
116 LARCH ST STE 300, SCRANTON, PA 18509-2802
(570) 489-5561
(570) 489-5563
Mailing address
851 COMMERCE BLVD, SUITE 107, DICKSON CITY, PA 18519-1677
(570) 489-5561
(570) 489-5563

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016274
PA
103TC0700X
Clinical Psychologist
PS016274
PA
225400000X
Rehabilitation Practitioner
SL005220 L
PA
235Z00000X
Speech-Language Pathologist
SL005220 L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001698460004
PA
01
163625
MEDPLUS
PA
01
201824875
PHCS
PA
01
2669826
AETNA HMO
PA
01
7777308
AETNA PPO
PA
01
819422
FIRST PRIORITY
PA
01
976357
HIGHMARK
PA
Enumeration date
12/01/2005
Last updated
01/24/2024
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