MEDICARE: DR. CHRISTINE MAYUMI HAMILTON PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY60109618	WA
2	103TC0700X	Clinical Psychologist	PSY.0004866	CO

General Provider Information

NPI Number	:	1801167903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE MAYUMI HAMILTON PSYD

Provider Business Mailing Address
First Line	:	430 BEACON LITE ROAD
Second Line	:	UNIT 140
City	:	MONUMENT
State	:	CO
Zip	:	80132
Country	:	US
Telephone Number	:	719-370-3839
Fax Number	:

Provider Business Practice Location Address
First Line	:	5350 TOMAH DR STE 1100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6902
Country	:	US
Telephone Number	:	719-466-6854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2012
Last Update Date	:	08/05/2021

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