Provider Demographics
NPI:1497014708
Name:HAMPTON LABOHN, DALE MARIE (BSHS)
Entity Type:Individual
Prefix:MS
First Name:DALE
Middle Name:MARIE
Last Name:HAMPTON LABOHN
Suffix:
Gender:F
Credentials:BSHS
Other - Prefix:MS
Other - First Name:DALE
Other - Middle Name:MARIE
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSHS
Mailing Address - Street 1:9328 MOUNTAIN RISE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7820
Mailing Address - Country:US
Mailing Address - Phone:908-674-1729
Mailing Address - Fax:
Practice Address - Street 1:9328 MOUNTAIN RISE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7820
Practice Address - Country:US
Practice Address - Phone:908-674-1729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner