Individual
SANDRA CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
048-0000411
VT
103TC0700X
Clinical Psychologist
Primary
048-0000411
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003256
—
VT
Enumeration date
11/11/2005
Last updated
03/17/2009
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