Provider Demographics
NPI:1144436049
Name:HAMILTON, JOANNE OLIVIA (MA, ATR-BC, LCAT)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:OLIVIA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCAT
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:OLIVIA
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ATR-BC, LCAT
Mailing Address - Street 1:4 BLAIR LN
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9543
Mailing Address - Country:US
Mailing Address - Phone:631-286-1944
Mailing Address - Fax:
Practice Address - Street 1:82 CARLETON AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-3016
Practice Address - Country:US
Practice Address - Phone:631-234-6324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001153221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist