Provider Demographics
NPI:1740625193
Name:HAMILTON, KIMBERLY ANN (OTR)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 W MILAN RD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:NH
Mailing Address - Zip Code:03588-3111
Mailing Address - Country:US
Mailing Address - Phone:603-723-4313
Mailing Address - Fax:
Practice Address - Street 1:349 W MILAN RD
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:NH
Practice Address - Zip Code:03588-3111
Practice Address - Country:US
Practice Address - Phone:603-723-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0642225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist