Individual
JAIAH INDIRAH CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58 CYNTHIAS PL APT 101, FREDERICKSBURG, VA 22406-7499
(540) 310-3511
Mailing address
58 CYNTHIAS PL APT 101, FREDERICKSBURG, VA 22406-7499
(540) 310-3511
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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