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General NPI Number Information
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NPI Number | 1780381137
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Entity Type | Individual
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Provider Name | TRACI MICHELLE HAMILTON
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Gender | Female
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 513 N D ST
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City | FREMONT
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State | NE
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Zip | 68025-5051
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Country | US
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Telephone | 402-816-4082
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 106
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City | HOOPER
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State | NE
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Zip | 68031-0106
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Country | US
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Telephone | 918-698-0689
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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