Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 071001608 | IL |
NPI | 1043440290 |
---|---|
Provider Name | Dr. Michael A Campion |
First Address | Champaign, IL 61822-8933 |
Second Address | Champaign, IL 61822-8933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 22/07/2009 |