Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor |
NPI | 1003055120 |
---|---|
Provider Name | Miss Shannon Hamilton |
First Address | Granada Hills, CA 91344-6342 |
Second Address | Granada Hills, CA 91344-6342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2009 |
Last Update Date | 19/05/2021 |