Provider Demographics
NPI:1861204141
Name:KAMPHUIS, ALLISON BETH
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:BETH
Last Name:KAMPHUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:BETH
Other - Last Name:HIRSHFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1324 20TH AVE SW STE 2
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6452
Mailing Address - Country:US
Mailing Address - Phone:701-858-0009
Mailing Address - Fax:
Practice Address - Street 1:1324 20TH AVE SW STE 2
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6452
Practice Address - Country:US
Practice Address - Phone:701-858-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician