Individual
CASSIE R CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2572
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203479
MEDCOST
NC
05
—
3810010805
—
WV
05
—
6107528
—
NC
01
—
811451
PARTNERS
NC
01
—
9340091
AETNA
NC
Enumeration date
10/09/2007
Last updated
10/11/2012
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