Provider Demographics
NPI:1073275327
Name:HAMILTON, DANNI NICOLE (NMD)
Entity Type:Individual
Prefix:
First Name:DANNI
Middle Name:NICOLE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23273 DOREMUS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2782
Mailing Address - Country:US
Mailing Address - Phone:260-602-6173
Mailing Address - Fax:
Practice Address - Street 1:23273 DOREMUS ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2782
Practice Address - Country:US
Practice Address - Phone:260-602-6173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21-1678175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath