Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1003303629 |
---|---|
Provider Name | Stephanie Manning Campbell |
First Address | Newport News, VA 23602-9665 |
Second Address | Newport News, VA 23602-9665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2018 |
Last Update Date | 19/04/2018 |