Provider Demographics
NPI:1306133046
Name:HAMILTON, MARY MARGARET (MED, BCBA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:
Practice Address - Street 1:1211 21ST AVE S
Practice Address - Street 2:SUITE 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2717
Practice Address - Country:US
Practice Address - Phone:615-343-4275
Practice Address - Fax:615-936-2763
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-08-4362103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst