Basic Information
| Provider Information | |||||||||
| NPI: | 1891079331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | CARI | ||||||||
| MiddleName: | BREANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 337 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840410337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017734840 | ||||||||
| FaxNumber: | 8015258151 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 N 1700 W | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840418803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017734840 | ||||||||
| FaxNumber: | 8015258151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2011 | ||||||||
| LastUpdateDate: | 02/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | UT | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 101YM0800X | 8634820-6004 | UT | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.