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General NPI Number Information
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NPI Number | 1558638015
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Entity Type | Individual
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Provider Name | DONALD WAYNE HAMILTON LMHC
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Gender | Male
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 1900 MOON ST. NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2853
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Country | US
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Telephone | 505-271-2490
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Fax | 505-271-2490
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Provider Business Mailing Address
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Address Line | 1900 MOON ST. NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2853
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Country | US
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Telephone | 505-271-2490
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Fax | 505-271-2490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0138681
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0138681
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License Number State | NM
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