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General NPI Number Information
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NPI Number | 1740424902
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Entity Type | Individual
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Provider Name | LON HAMILTON JR. PH. D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 3502 18TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20018-2738
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Country | US
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Telephone | 240-533-6657
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 FURMAN CT
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City | RIVERDALE
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State | MD
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Zip | 20737-3009
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Country | US
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Telephone | 240-533-6657
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PRC608
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License Number State | DC
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