MEDICARE: DR. EMILY A. HAMILTON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2008032257	MO
2	103TC0700X	Clinical Psychologist	PSY.0003996	CO

General Provider Information

NPI Number	:	1417278961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY A. HAMILTON PH.D.

Provider Business Mailing Address
First Line	:	954 NORTH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3419
Country	:	US
Telephone Number	:	303-747-5425
Fax Number	:	303-530-8488

Provider Business Practice Location Address
First Line	:	954 NORTH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3419
Country	:	US
Telephone Number	:	303-747-5425
Fax Number	:	303-530-8488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	08/06/2014

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