Provider Demographics
NPI:1770201840
Name:HAMILTON, QUIN'DE'JA (BS)
Entity type:Individual
Prefix:
First Name:QUIN'DE'JA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 GROVE POINT RD APT 804
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-8516
Mailing Address - Country:US
Mailing Address - Phone:706-251-1482
Mailing Address - Fax:
Practice Address - Street 1:1332 SOUTHERN DR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30460-1360
Practice Address - Country:US
Practice Address - Phone:706-251-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer