Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | IN |
NPI | 1003102062 |
---|---|
Provider Name | Cha'reme Campbell |
First Address | Jeffersonville, IN 47130-3084 |
Second Address | Jeffersonville, IN 47130-3084 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 05/02/2019 |