Healthcare Provider Details

I. General information

NPI: 1104631332
Provider Name (Legal Business Name): AMBER LEIGH HAMPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 MAYO DR
BARLING AR
72923-1660
US

IV. Provider business mailing address

1102 N 28TH PL
VAN BUREN AR
72956-3800
US

V. Phone/Fax

Practice location:
  • Phone: 479-494-5700
  • Fax:
Mailing address:
  • Phone: 479-235-0785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA2510009
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: