Provider Demographics
NPI:1073863692
Name:BATISTA-HAMILTON, GLEN MARIE (BS)
Entity type:Individual
Prefix:MRS
First Name:GLEN
Middle Name:MARIE
Last Name:BATISTA-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 1:2509 BARRINGTON CIR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6800
Mailing Address - Country:US
Mailing Address - Phone:850-519-4644
Mailing Address - Fax:850-386-2118
Practice Address - Street 1:2509 BARRINGTON CIR
Practice Address - Street 2:SUITE 116
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-6800
Practice Address - Country:US
Practice Address - Phone:850-519-4644
Practice Address - Fax:850-386-2118
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator