Provider Demographics
NPI:1720188444
Name:HAMILTON, MARIANNE ROBERTA (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:ROBERTA
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:MISS
Other - First Name:MARIANNE
Other - Middle Name:ROBERTA
Other - Last Name:FERRESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7953 S. OLIVE CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:303-902-2438
Mailing Address - Fax:
Practice Address - Street 1:5636 N. UNION BLVD.
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-329-7117
Practice Address - Fax:719-260-1821
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD354231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist