Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 11134 | TX |
Y | 111NN1001X | Nutrition | 11134 | TX |
NPI | 1588891774 |
---|---|
Provider Name | Stephanie Hamilton |
First Address | Allen, TX 75013-2632 |
Second Address | Allen, TX 75013-2632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 16/06/2009 |