Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1215300272 |
---|---|
Provider Name | Miss Cosette Annette Hampton |
First Address | New York City, NY 10033-1437 |
Second Address | New York City, NY 10033-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2015 |
Last Update Date | 12/11/2015 |