Provider Demographics
NPI:1528789583
Name:HAMILTON, MAKENZY ANN (MS)
Entity type:Individual
Prefix:
First Name:MAKENZY
Middle Name:ANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-0026
Mailing Address - Country:US
Mailing Address - Phone:501-467-5095
Mailing Address - Fax:
Practice Address - Street 1:600 MAIN ST STE L
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4964
Practice Address - Country:US
Practice Address - Phone:501-332-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR201996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty