Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 99155 | TX |
N | 101Y00000X | Counselor | CSAT 2002C-0125 | AZ |
Y | 1041C0700X | Clinical Social Worker | 6024 | TX |
NPI | 1003054792 |
---|---|
Provider Name | Cheryl Edwards Campbell |
First Address | Argyle, TX 76226-0484 |
Second Address | Denton, TX 76201-2954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 03/02/2009 |