Individual
BENJAMIN MICHAEL CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
104 W 4TH ST STE 204, ROYAL OAK, MI 48067-3803
(248) 504-2275
Mailing address
23767 BATTELLE AVE, HAZEL PARK, MI 48030-1422
(310) 745-9834
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301018072
MI
Other
Enumeration date
08/27/2019
Last updated
06/29/2022
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