Individual
JENNIFER PATRICIA CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, CCDP-D
Contact information
Practice address
939 GARDENVIEW OFFICE PKWY, CREVE COEUR, MO 63141-5917
(314) 566-2290
Mailing address
9433 THEODOSIA AVE, OVERLAND, MO 63114-3715
(314) 566-2290
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2008010475
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
5030
MO
101YP2500X
Professional Counselor
Primary
2008010475
MO
Other
Enumeration date
02/06/2010
Last updated
02/06/2010
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