Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | NV |
NPI | 1093105181 |
---|---|
Provider Name | Raquel Campbell |
First Address | North Las Vegas, NV 89032-0628 |
Second Address | North Las Vegas, NV 89032-0628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2015 |
Last Update Date | 28/01/2015 |