Individual
MRS. MARY LAVINIA CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWR, CDE
Contact information
Practice address
80 E 11TH ST, 438, NEW YORK, NY 10003-6811
(212) 533-3884
(718) 855-3004
Mailing address
80 E 11TH ST, 438, NEW YORK, NY 10003-6811
(212) 533-3884
(718) 855-3004
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
R-0376750
NY
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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