Provider Demographics
NPI:1437362332
Name:HAMILTON, DANIELLE (OTRL)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BROAD ST
Mailing Address - Street 2:APT 8
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6335
Mailing Address - Country:US
Mailing Address - Phone:207-286-7569
Mailing Address - Fax:207-945-8645
Practice Address - Street 1:1 CUMBERLAND PL
Practice Address - Street 2:SUITE 108
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5083
Practice Address - Country:US
Practice Address - Phone:207-990-9000
Practice Address - Fax:207-945-8645
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTOT1906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist