Provider Demographics
NPI:1669024170
Name:HAMLIN, PATRICIA DIANE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DIANE
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 ACTON CIR
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9210
Mailing Address - Country:US
Mailing Address - Phone:828-251-2882
Mailing Address - Fax:828-633-7073
Practice Address - Street 1:90 ACTON CIR
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9210
Practice Address - Country:US
Practice Address - Phone:828-251-2882
Practice Address - Fax:828-633-7073
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14296101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty