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Individual

MR. GABRIEL DYLAN CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS LPC

Contact information

Practice address
3801 LAKE BOONE TRL, RALEIGH, NC 27607-2934
(919) 784-9182
Mailing address
109 BROOK HOLLOW CT, CARY, NC 27513-4932

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4558
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6103011
NC
Enumeration date
11/15/2006
Last updated
07/08/2007
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