Provider Demographics
NPI:1811064322
Name:HAMLETT, VANESSA LINNETTE (MA)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:LINNETTE
Last Name:HAMLETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 CEDARCREST LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-4631
Mailing Address - Country:US
Mailing Address - Phone:817-370-9970
Mailing Address - Fax:206-339-4554
Practice Address - Street 1:8217 CEDARCREST LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-4631
Practice Address - Country:US
Practice Address - Phone:817-370-1223
Practice Address - Fax:206-339-4554
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84825LOtherBLUE CROSS BLUE SHIELD