Provider Demographics
NPI:1700251402
Name:OCAMPO, CLARISSA M (SLPCF)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:M
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:SLPCF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 COLLEGE STREET
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075
Mailing Address - Country:US
Mailing Address - Phone:413-331-9806
Mailing Address - Fax:
Practice Address - Street 1:7501 OSLER DR STE 301
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7744
Practice Address - Country:US
Practice Address - Phone:410-337-1349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist