Provider Demographics
NPI:1104400605
Name:HAMPP, EMILY M
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:HAMPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 MADIOSN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206
Mailing Address - Country:US
Mailing Address - Phone:513-354-5200
Mailing Address - Fax:513-354-7115
Practice Address - Street 1:1501 MADIOSN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206
Practice Address - Country:US
Practice Address - Phone:513-354-5200
Practice Address - Fax:513-354-7115
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204296101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK00000OtherLICENSURE BOARD