Provider Demographics
NPI:1346487048
Name:HAMILTON, NANCY LYNN (MS, BCBA, LMHCA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS, BCBA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 NE CRYSTAL PEAK LN
Mailing Address - Street 2:#DD201
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-6840
Mailing Address - Country:US
Mailing Address - Phone:360-731-7728
Mailing Address - Fax:
Practice Address - Street 1:1310 NE CRYSTAL PEAK LN
Practice Address - Street 2:#DD201
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-6840
Practice Address - Country:US
Practice Address - Phone:360-731-7728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-08-4654103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-08-4654OtherBOARD CERTIFIED BEHAVIOR ANALYST
WAMC60141971OtherDEPARTMENT OF HEALTH