Provider Demographics
NPI:1982984266
Name:HAMILTON, PATRICIA ANNE (MS,LPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-3048
Mailing Address - Country:US
Mailing Address - Phone:361-992-7780
Mailing Address - Fax:361-992-3355
Practice Address - Street 1:5402 HOLLY RD STE 104
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4674
Practice Address - Country:US
Practice Address - Phone:361-992-7780
Practice Address - Fax:361-992-3355
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64945101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional