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Individual

KIMBERLIE CAMPBELL-GLASCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2633 S LAPEER RD, ORION, MI 48360
(248) 393-5555
Mailing address
1169 QUAIL RIDGE DR, OXFORD, MI 48371-6075
(248) 969-4977

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
Mental Health Counselor
6401008053
MI
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
6301012072
MI

Other

Enumeration date
03/26/2007
Last updated
10/17/2018
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