Provider Demographics
NPI:1790390318
Name:HAMLIN, KENDALL AUDREY
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:AUDREY
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 1:8686 SCORTON HARBOUR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6512
Mailing Address - Country:US
Mailing Address - Phone:301-789-7834
Mailing Address - Fax:
Practice Address - Street 1:8686 SCORTON HARBOUR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6512
Practice Address - Country:US
Practice Address - Phone:301-789-7834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician