Individual
BRANDI CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, MHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
(618) 658-2501
Mailing address
917 S 10TH ST, HERRIN, IL 62948-4209
(618) 303-6161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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