Provider Demographics
NPI:1609099720
Name:HAMPTON, JEANNE BETH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:BETH
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 ALTA VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2077
Mailing Address - Country:US
Mailing Address - Phone:870-234-1470
Mailing Address - Fax:870-901-7254
Practice Address - Street 1:1115 FAIRVIEW RD SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-6416
Practice Address - Country:US
Practice Address - Phone:870-231-4000
Practice Address - Fax:870-231-4006
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1483235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134620721Medicaid