MISS Autumn Victoria Grace Hampton, MASTERS PSYCHOLOGY

NPI #1699370809 in Edgewater, Florida

Provider Information

NPI Number: 1699370809
Entity Type: Individual
Name: MISS Autumn Victoria Grace Hampton, MASTERS PSYCHOLOGY
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: MASTERS PSYCHOLOGY
Enumeration Date: Dec 3, 2020
Last Updated: Dec 3, 2020

Practice Location

Address: 648 CORAL TRACE BLVD
City: Edgewater
State: Florida
ZIP Code: 32132-6942
Phone: (606) 259-6072

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Counselor	101Y00000X	Primary

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