Provider Demographics
NPI:1306059027
Name:HAMILTON, KAREN DENISE (MRC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 CRONE RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6614
Mailing Address - Country:US
Mailing Address - Phone:937-431-1046
Mailing Address - Fax:937-431-1073
Practice Address - Street 1:2703 CRONE RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6614
Practice Address - Country:US
Practice Address - Phone:937-431-1046
Practice Address - Fax:937-431-1073
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00011198171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator