Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | KY-0086 | KY |
NPI | 1013204502 |
---|---|
Provider Name | Velma Lee Campbell |
First Address | Morehead, KY 40351-1179 |
Second Address | Morehead, KY 40351-1179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 05/07/2011 |