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Individual
MS. MARY ANNE CAMPBELL
Active
Individual
MS. MARY ANNE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003949
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004254976
CTBP
CT
01
—
061363844
TAX ID
CT
01
—
140889
VALUE OPTIONS
CT
Enumeration date
09/02/2006
Last updated
02/24/2016
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