MEDICARE: MS. BRANDI JO HAMPSHIRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164673786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRANDI JO HAMPSHIRE

Provider Business Mailing Address
First Line	:	166 RACHELLE PL
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544-2000
Country	:	US
Telephone Number	:	931-265-9373
Fax Number	:

Provider Business Practice Location Address
First Line	:	166 RACHELLE PL
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544-2000
Country	:	US
Telephone Number	:	931-265-9373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	11/16/2019

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