Provider Demographics
NPI:1356877906
Name:HAMPTON, CORINA LOUISE (MED, BCBA)
Entity type:Individual
Prefix:
First Name:CORINA
Middle Name:LOUISE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 13TH AVE
Mailing Address - Street 2:APT 509
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2569
Mailing Address - Country:US
Mailing Address - Phone:916-397-8046
Mailing Address - Fax:
Practice Address - Street 1:1601 13TH AVE
Practice Address - Street 2:APT 509
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2569
Practice Address - Country:US
Practice Address - Phone:916-397-8046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-17-25380103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst