Individual
TED CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 MOORE ST, FAIRBANKS, AK 99701-5761
(907) 452-8251
Mailing address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
09/05/2024
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