Provider Demographics
NPI:1750427878
Name:HAMILTON, CHRIS MICHELLE (MS-CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CHRIS
Middle Name:MICHELLE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:MICHELLE HAMILTON
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS-CCC-SLP
Mailing Address - Street 1:4173 28TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3919
Mailing Address - Country:US
Mailing Address - Phone:727-767-8089
Mailing Address - Fax:
Practice Address - Street 1:801 6TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4816
Practice Address - Country:US
Practice Address - Phone:727-767-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ3907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist