Individual
DOREEN T CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1574 STATE ROAD 502, SANTA FE, NM 87506-2697
(505) 455-4026
(505) 455-4038
Mailing address
P O BOX 237, EL RITO, NM 87530
(575) 581-4728
(575) 581-0030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
08/30/2010
Last updated
05/20/2015
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