Provider Demographics
NPI:1275274045
Name:HAMPSHIRE, PATRICIA KORZEKWA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:KORZEKWA
Last Name:HAMPSHIRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8003
Mailing Address - Country:US
Mailing Address - Phone:503-267-8711
Mailing Address - Fax:
Practice Address - Street 1:1406 E BANNOCK ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-8003
Practice Address - Country:US
Practice Address - Phone:503-267-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician