Provider Demographics
NPI:1255522918
Name:HAMPTON, LINDA GAIL (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GAIL
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 HAZEL ST
Mailing Address - Street 2:SUITE 3-E
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-2501
Mailing Address - Country:US
Mailing Address - Phone:870-904-2789
Mailing Address - Fax:
Practice Address - Street 1:1301 HAZEL ST
Practice Address - Street 2:SUITE 3-E
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-2501
Practice Address - Country:US
Practice Address - Phone:870-904-2789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19608235Z00000X
AR738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR738OtherARKANSAS BOARD OF EXAMINE
TX19608OtherTEXAR DEPARTMENT OF HEALT