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Individual

MS. JEAN AMOS CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
3044 BRECKENRIDGE LN, SUITE 204, LOUISVILLE, KY 40220-2192
(502) 493-0343
(502) 493-0343
Mailing address
3044 BRECKENRIDGE LN, SUITE 204, LOUISVILLE, KY 40220-2192
(502) 493-0343
(502) 493-0343

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0012
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
099696
VALUEOPTIONS PROVIDER #
KY
Enumeration date
12/27/2006
Last updated
07/08/2007
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