Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH00010420 | WA |
NPI | 1003039546 |
---|---|
Provider Name | Mrs. Amy Patton Campbell |
First Address | Kennewick, WA 99336-7160 |
Second Address | Kennewick, WA 99336-7160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |