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General NPI Number Information
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NPI Number | 1679018055
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Entity Type | Individual
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Provider Name | JAIME HAMPTON MA
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Gender | Female
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 1820 S RIDGE RD W
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City | ASHTABULA
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State | OH
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Zip | 44004-9039
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Country | US
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Telephone | 440-381-8107
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 441
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City | ASHTABULA
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State | OH
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Zip | 44005-0441
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Country | US
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Telephone | 440-381-8107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.1500537
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1901058
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License Number State | OH
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