Provider Demographics
NPI:1306255153
Name:HAMILTON, CHERYL (EDD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E WHEATLAND RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4918
Mailing Address - Country:US
Mailing Address - Phone:972-283-6799
Mailing Address - Fax:
Practice Address - Street 1:777 E WHEATLAND RD STE 101
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4918
Practice Address - Country:US
Practice Address - Phone:972-283-6799
Practice Address - Fax:877-837-1492
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70123101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor