Healthcare Provider Details

I. General information

NPI: 1699533158
Provider Name (Legal Business Name): NATALIE R JOHNSON HAMILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 LEHIGH STREET
BETHLEHEM PA
18017
US

IV. Provider business mailing address

150 CHAMBERLAINE AVE
POTTSVILLE PA
17901-8648
US

V. Phone/Fax

Practice location:
  • Phone: 610-865-4300
  • Fax:
Mailing address:
  • Phone: 570-593-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1699533158
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: