Provider Demographics
NPI:1316386089
Name:HAMILTON, SANDRA JOY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JOY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:LEBLANC
Mailing Address - State:LA
Mailing Address - Zip Code:70651-0102
Mailing Address - Country:US
Mailing Address - Phone:337-224-1841
Mailing Address - Fax:
Practice Address - Street 1:109 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4061
Practice Address - Country:US
Practice Address - Phone:337-463-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA3144225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist