Provider Demographics
NPI:1588832927
Name:HAMILTON, KINDRETH D (LIC AC, MAOM, MS)
Entity Type:Individual
Prefix:
First Name:KINDRETH
Middle Name:D
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LIC AC, MAOM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 COLLEGE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-6461
Mailing Address - Country:US
Mailing Address - Phone:413-535-9930
Mailing Address - Fax:
Practice Address - Street 1:27 COLLEGE ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075
Practice Address - Country:US
Practice Address - Phone:413-535-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233877171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist