Individual
MS. JENNIFER LYNN HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. LCPC
Contact information
Practice address
112 BOEYKENS PL, SUITE 4A, NORMAL, IL 61761-2152
(309) 830-4553
Mailing address
211 KREITZER AVE, BLOOMINGTON, IL 61701-5637
(309) 830-4553
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180-003930
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932460
BC/BS
IL
Enumeration date
06/15/2006
Last updated
10/04/2016
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