Provider Demographics
NPI:1205543980
Name:HAMILTON, EMILY MARIE (MMFT, LMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 SLIDE RD STE 24
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2828
Mailing Address - Country:US
Mailing Address - Phone:806-853-7146
Mailing Address - Fax:
Practice Address - Street 1:8008 SLIDE RD STE 24
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2828
Practice Address - Country:US
Practice Address - Phone:806-853-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203334106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist