Provider Demographics
NPI:1629374798
Name:HAMPE, CATHERINE ROSE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ROSE
Last Name:HAMPE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 SE FALLON DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2637
Mailing Address - Country:US
Mailing Address - Phone:570-335-7586
Mailing Address - Fax:
Practice Address - Street 1:502 SE FALLON DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2637
Practice Address - Country:US
Practice Address - Phone:570-335-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 30052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer