Provider Demographics
NPI:1700926003
Name:HAMPTON, IRMGARD MARIA (QMHA)
Entity Type:Individual
Prefix:MS
First Name:IRMGARD
Middle Name:MARIA
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-0010
Mailing Address - Country:US
Mailing Address - Phone:541-997-6261
Mailing Address - Fax:541-997-8606
Practice Address - Street 1:1445 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439
Practice Address - Country:US
Practice Address - Phone:541-997-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker