Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 82-30EI | AR |
NPI | 1124274469 |
---|---|
Provider Name | Mr. Lewis E. Campbell |
First Address | North Little Rock, AR 72116-7034 |
Second Address | North Little Rock, AR 72116-7034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 18/08/2008 |