Individual
AMBER CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 W MAIN ST, LEESBURG, FL 34748-2841
(352) 314-3760
Mailing address
6891 SE 103RD PL, BELLEVIEW, FL 34420-9324
(352) 504-6881
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023021000
—
FL
Enumeration date
11/03/2017
Last updated
10/11/2022
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