Individual
LAWANDA HARLEY-HAMPTON X
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 N.W. SUMMERCREST BLVD., APT. 211, BURLESON, TX 76028-9434
(708) 305-0855
Mailing address
1320 N.W. SUMMERCREST BLVD., APT. 211, BURLESON, TX 76028-9434
(708) 305-0855
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
41169749
TX
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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