Provider Demographics
NPI:1982184149
Name:HAMPTON, VIRGINIA FELDICK (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:FELDICK
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 1:303 WESTGATE CIR
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-9008
Mailing Address - Country:US
Mailing Address - Phone:919-434-7294
Mailing Address - Fax:
Practice Address - Street 1:COASTAL THERAPY PARTNERS
Practice Address - Street 2:210 LIBERTY HILL ROAD
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358
Practice Address - Country:US
Practice Address - Phone:910-272-9056
Practice Address - Fax:910-272-9057
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty