Individual
IDEN CAMPBELL MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
CPS
Contact information
Practice address
700 PENNSYLVANIA AVE SE FL 2, WASHINGTON, DC 20003-2493
(888) 963-1828
Mailing address
55 COURT ST STE 220B, BOSTON, MA 02108-2104
(888) 963-1828
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
043
DC
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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