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Individual
JASON SHANE CAMPBELL IV
Active
Individual
JASON SHANE CAMPBELL IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHPP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/14/2007
Last updated
11/01/2010
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