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Individual

DR. MARTHA L HAMILTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
100 W MAIN ST, THIBODAUX, LA 70301-5216
(985) 447-6214
Mailing address
PO BOX 416, NORCO, LA 70079-0416
(504) 487-7719

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
787
LA
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
Primary
787
LA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
787
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1170291
LA
Enumeration date
02/14/2007
Last updated
10/26/2011
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