Individual
MS. DOMINIQUE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 E APOLLO RD, PHOENIX, AZ 85042-4446
(480) 321-5631
Mailing address
1417 E APOLLO RD, PHOENIX, AZ 85042-4446
(480) 321-5631
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3598310
AZ
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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