Provider Demographics
NPI:1952324824
Name:HAMPTON, HEATHER D (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9339 CORYDON GENEVA RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-9053
Mailing Address - Country:US
Mailing Address - Phone:270-533-6382
Mailing Address - Fax:
Practice Address - Street 1:810 PRINCETON PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6166
Practice Address - Country:US
Practice Address - Phone:270-926-2212
Practice Address - Fax:270-926-2215
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist