Healthcare Provider Details

I. General information

NPI: 1831581354
Provider Name (Legal Business Name): KERRI HAMPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LAUREL RIDGE LN
LITITZ PA
17543-7978
US

IV. Provider business mailing address

17 LAUREL RIDGE LN
LITITZ PA
17543-7978
US

V. Phone/Fax

Practice location:
  • Phone: 718-327-6576
  • Fax:
Mailing address:
  • Phone: 718-327-6576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberOC006700L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. KERRI HAMPLE
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 717-327-6576