Provider Demographics
NPI:1952965360
Name:HAMILTON, MICHELLE YODER (PHD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:YODER
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:814 SAINT CLAIR AVE APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4919
Mailing Address - Country:US
Mailing Address - Phone:301-221-7133
Mailing Address - Fax:
Practice Address - Street 1:3500 REMSON CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3508
Practice Address - Country:US
Practice Address - Phone:434-923-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810007478103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0810007478OtherSTATE LICENSING BOARD