Individual
LORI K CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
3925 E HAGAN ST, STE 102, BLOOMINGTON, IN 47401-8649
(812) 336-1994
Mailing address
3925 E HAGAN ST, STE 102, BLOOMINGTON, IN 47401-8649
(812) 336-1994
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041374A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201267940 A
—
IN
Enumeration date
11/24/2014
Last updated
04/14/2015
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