Provider Demographics
NPI:1316203078
Name:HAMILL, LINDA ROSE (PLPC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ROSE
Last Name:HAMILL
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 N US HIGHWAY 67
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5130
Mailing Address - Country:US
Mailing Address - Phone:314-830-9970
Mailing Address - Fax:
Practice Address - Street 1:580 N US HIGHWAY 67
Practice Address - Street 2:SUITE 9
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5130
Practice Address - Country:US
Practice Address - Phone:314-830-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011030021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional