Provider Demographics
NPI:1891852364
Name:HAMP, GINGER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:HAMP
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 1:805 S SYCAMORE UNIT 234
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-1945
Mailing Address - Country:US
Mailing Address - Phone:602-332-4256
Mailing Address - Fax:
Practice Address - Street 1:63 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-7422
Practice Address - Country:US
Practice Address - Phone:480-472-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP 4509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist