Individual
LARISSA HAMPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
(920) 648-8344
Mailing address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
(920) 648-8344
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5445-26
WI
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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