Provider Demographics
NPI:1396179370
Name:HAMPTON, CAROLYLN KAY
Entity Type:Individual
Prefix:
First Name:CAROLYLN
Middle Name:KAY
Last Name:HAMPTON
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:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:SAWYER
Mailing Address - State:OK
Mailing Address - Zip Code:74756-0203
Mailing Address - Country:US
Mailing Address - Phone:580-326-3829
Mailing Address - Fax:
Practice Address - Street 1:1410 S GIN RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-7348
Practice Address - Country:US
Practice Address - Phone:580-326-3829
Practice Address - Fax:580-889-3887
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health