Provider Demographics
NPI:1104835289
Name:HAMILTON, DONNA M (MFT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15155 TIMBER CREST TRL
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8224
Mailing Address - Country:US
Mailing Address - Phone:775-849-2066
Mailing Address - Fax:775-825-8997
Practice Address - Street 1:645 SIERRA ROSE DR
Practice Address - Street 2:STE 201
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2060
Practice Address - Country:US
Practice Address - Phone:775-825-4141
Practice Address - Fax:775-825-8997
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0865106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0865OtherLICENSE