Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | C.1300662 | OH |
NPI | 1003452293 |
---|---|
Provider Name | Mrs. Sharece Necole Campbell |
First Address | Erie, PA 16505-2233 |
Second Address | Erie, PA 16505-2233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2019 |
Last Update Date | 21/11/2019 |