Healthcare Provider Details

I. General information

NPI: 1285554865
Provider Name (Legal Business Name): MICHELLE R HAMPTON BA, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 STACEY PL APT A
JONESBURG MO
63351-2258
US

IV. Provider business mailing address

105 STACEY PL APT A
JONESBURG MO
63351-2258
US

V. Phone/Fax

Practice location:
  • Phone: 314-437-0526
  • Fax:
Mailing address:
  • Phone: 314-437-0526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: