Individual
EDNA LEA CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-S
Contact information
Practice address
2224 APACHE ST, CHOCTAW, OK 73020-3005
(708) 882-7484
Mailing address
2224 APACHE ST, CHOCTAW, OK 73020-3005
(708) 882-7484
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10228
OK
101YP2500X
Professional Counselor
Primary
P1609141
AR
Other
Enumeration date
04/22/2014
Last updated
11/13/2024
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