Individual
NICOLE HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7330 FERN AVE STE 1001, SHREVEPORT, LA 71105-4988
(318) 641-3083
Mailing address
4348 ILLINOIS AVE, SHREVEPORT, LA 71109-6822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R9385
LA
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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