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Individual

JEFFREY J CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-7600
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8343
(920) 926-8370

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6642123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39757500
WI
Enumeration date
07/07/2006
Last updated
10/22/2020
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