Provider Demographics
NPI:1730671041
Name:HAMILTON, MEGHAN MARIE (RBT)
Entity Type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:MARIE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10940 S MILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-3317
Mailing Address - Country:US
Mailing Address - Phone:773-420-6968
Mailing Address - Fax:
Practice Address - Street 1:10940 S MILLARD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-3317
Practice Address - Country:US
Practice Address - Phone:773-420-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17-39646106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician