Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 04-05P | AR |
Y | 103G00000X | Clinical Psychologist | 04-05P | AR |
Y | 103TC0700X | Clinical Psychologist | 04-05P | AR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 04-05P | AR |
N | 103TP2701X | Group Psychotherapist | 04-05P |
NPI | 1316359722 |
---|---|
Provider Name | Dr. Maria Hamilton |
First Address | Surprise, AZ 85374-0834 |
Second Address | Surprise, AZ 85374-0834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2014 |
Last Update Date | 20/05/2014 |