Individual
MRS. AMANDA JILL CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
120 CAMILLA CT, SUITE D, WESTFIELD, IN 46074-9863
(618) 554-2830
Mailing address
120 CAMILLA CT, SUITE D, WESTFIELD, IN 46074-9863
(618) 554-2830
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002707A
IN
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376006178008
—
IL
Enumeration date
10/04/2007
Last updated
10/13/2015
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