Provider Demographics
NPI:1689731929
Name:HAMILTON, MICHELLE RENEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:RENEE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9180 ESTERO PARK COMMONS BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3218
Mailing Address - Country:US
Mailing Address - Phone:239-495-7773
Mailing Address - Fax:239-495-7772
Practice Address - Street 1:9180 ESTERO PARK COMMONS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3218
Practice Address - Country:US
Practice Address - Phone:239-495-7773
Practice Address - Fax:239-495-7772
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist