Provider Demographics
NPI:1538286976
Name:HAMPTON, ALESIA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:M
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 SHEARWATER CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-8163
Mailing Address - Country:US
Mailing Address - Phone:765-538-3348
Mailing Address - Fax:765-538-3357
Practice Address - Street 1:4908 SHEARWATER CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-8163
Practice Address - Country:US
Practice Address - Phone:765-538-3348
Practice Address - Fax:765-538-3357
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003125A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist