Individual
DR. BRIAN MATTHEW CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
405 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3586
(407) 322-6868
Mailing address
405 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3586
(407) 322-6868
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0004142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005337111
AETNA PIN BRIAN CAMPBELL
FL
01
—
053111
VALUE OPTIONS
FL
01
—
1467491829
NPI NEW LIFE CHRISTIAN C
FL
01
—
73535
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/08/2007
Last updated
07/08/2007
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