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General NPI Number Information
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NPI Number | 1639415565
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Entity Type | Organization
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Legal Business Name | SHANA V. HAMILTON-LOCKWOOD, PHD PLLC
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 204 BIRCHWOOD LANE
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City | SEVIERVILLE
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State | TN
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Zip | 37862
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Country | US
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Telephone | 865-556-3474
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Fax | 865-525-7494
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Provider Business Mailing Address
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Address Line | 204 BIRCHWOOD LANE
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City | SEVIERVILLE
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State | TN
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Zip | 37862
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Country | US
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Telephone | 865-556-3474
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Fax | 865-525-7494
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. SHANA VALERE HAMILTON
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Credential | PH.D.
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Telephone | 865-556-3474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P2839
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License Number State | TN
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