Healthcare Provider Details

I. General information

NPI: 1851045439
Provider Name (Legal Business Name): MICHELLE HAMILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 VETERANS PKWY STE 301
COLUMBUS GA
31904-3471
US

IV. Provider business mailing address

243 OAKLEY DR APT 53
COLUMBUS GA
31906-4696
US

V. Phone/Fax

Practice location:
  • Phone: 706-905-5525
  • Fax:
Mailing address:
  • Phone: 706-330-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberLABA000088
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: